Organization
ROSS VAN ANTWERP DO MPH PA LASER CENTER OF MARYLAND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSS JAMES VANANTWERP D.O. (PRESIDENT)
(410) 544-4600
Entity
Organization
Contact information
Practice address
484 RITCHIE HWY STE A, SEVERNA PARK, MD 21146-2911
(410) 544-4600
(410) 544-0997
Mailing address
484 RITCHIE HWY STE A, SEVERNA PARK, MD 21146-2961
(410) 544-4600
(410) 544-0997
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
H0033830
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8581RJ
GRP
MD
Enumeration date
09/21/2007
Last updated
03/30/2009
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