Organization
INTERMED IPA CTO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VAN LOMIS MD (VICE PRESIDENT)
(410) 371-4492
Entity
Organization
Contact information
Practice address
9106 PHILADELPHIA RD STE 214, BALTIMORE, MD 21237-4333
(410) 780-1980
Mailing address
9106 PHILADELPHIA RD STE 214, BALTIMORE, MD 21237-4333
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
11/07/2019
Last updated
11/07/2019
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