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Organization

PARK MEDICAL ASSOCIATES NON-PAR LLC

Active
Parent organization
PARK MEDICAL ASSOCIATES LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
PARK MEDICAL ASSOCIATES LLC
Authorized official
JOHN AUCOTT (MEMBER)
(410) 583-7124
Entity
Organization

Contact information

Practice address
10755 FALLS RD, SUITE 200, LUTHERVILLE, MD 21093-4515
(410) 583-7101
Mailing address
10755 FALLS RD, SUITE 200, LUTHERVILLE, MD 21093-4515

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary

Other

Enumeration date
07/13/2010
Last updated
07/13/2010
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