Organization
OPAL MEDICAL GROUP, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMY RENEE HOSE (OFFICE MANAGER)
(240) 420-6909
Entity
Organization
Contact information
Practice address
1126 OPAL COURT, HAGERSTOWN, MD 21740
(240) 420-2666
(240) 420-0951
Mailing address
1126 OPAL COURT, HAGERSTOWN, MD 21740
(240) 420-2666
(240) 420-0951
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D52323
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
404343000
—
MD
Enumeration date
10/27/2006
Last updated
02/24/2010
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