Organization
SPECIALTY PHYSICIANS OF GARRETT
Active
Parent organization
SPECIALTY PHYSICIANS OF GARRETT COUNTY LLC
Other names
Specialty Physicians of Garrett
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPECIALTY PHYSICIANS OF GARRETT COUNTY LLC
Authorized official
MICHELE A BIRKBY-VANCE (DO, BILLING OFFICE MANAGER)
(301) 895-8749
Entity
Organization
Contact information
Practice address
32 CORPORATE DR, GRANTSVILLE, MD 21536-1259
(301) 895-8750
(301) 895-8751
Mailing address
PO BOX 594, OAKLAND, MD 21550-4594
(301) 895-8750
(301) 895-8751
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
541184000
—
MD
Enumeration date
05/14/2019
Last updated
05/14/2019
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