Organization
ST JOHNS COLLEGE HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES IRUNGU (CREDENTIALING MANAGER)
(877) 614-5227
Entity
Organization
Contact information
Practice address
60 COLLEGE AVE, ANNAPOLIS, MD 21401-1687
(410) 626-2553
Mailing address
60 COLLEGE AVE, ANNAPOLIS, MD 21401-1687
(410) 626-2553
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R063769
MD
Other
Enumeration date
04/05/2012
Last updated
04/05/2012
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