Organization
ISLAND MEDICAL SP LLC
Active
Other names
Island Medical SP, LLC-Monroe
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMY CHARLEY ESQ (CHIEF LEGAL OFFICER)
(240) 686-2300
Entity
Organization
Contact information
Practice address
309 JACKSON ST, MONROE, LA 71201-7407
(406) 862-3002
Mailing address
12420 MILESTONE CENTER DR STE 200, GERMANTOWN, MD 20876-7111
(240) 686-2300
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
07/19/2012
Last updated
06/03/2020
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