Organization
CALVERT INTERNAL MEDICINE GROUP, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA A GATES (CREDENTIALING SPECIALIST)
(410) 535-7068
Entity
Organization
Contact information
Practice address
110 HOSPITAL RD, SUITE 310, PRINCE FREDERICK, MD 20678-4019
(410) 535-2005
Mailing address
110 HOSPITAL RD, SUITE 310, PRINCE FREDERICK, MD 20678-4019
(410) 535-2005
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
R144667
MD
Other
Enumeration date
03/09/2015
Last updated
03/09/2015
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