Organization
BODYWORKS MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILLIP SHERMAN RAGLAND MD (PRESIDENT)
(240) 448-3279
Entity
Organization
Contact information
Practice address
ST. AGNES MEDICAL CENTER, 3455 WILKENS AVE SUITE 100, BALTIMORE, MD 21229
(240) 447-8036
Mailing address
13013 DAVENPORT DR, BRANDYWINE, MD 20613-5683
(202) 270-7542
(240) 213-2335
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
968419100
—
MD
Enumeration date
03/20/2020
Last updated
03/20/2020
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