Organization
MLM ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELLE MOYLAN (CRNA)
(410) 703-1111
Entity
Organization
Contact information
Practice address
12205 TULLAMORE RD, TIMONIUM, MD 21093-7816
(410) 308-4701
Mailing address
305 WYE HARBOR DR, QUEENSTOWN, MD 21658-1638
(410) 703-1111
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
01/24/2020
Last updated
01/24/2020
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