Organization
GATEWAY MEDICAL PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IULIANA KETA SELARU MD (OWNER)
(443) 878-7087
Entity
Organization
Contact information
Practice address
7226 LEE DEFOREST DR, SUITE 206, COLUMBIA, MD 21046-3239
(443) 878-7087
Mailing address
7226 LEE DEFOREST DR, SUITE 206, COLUMBIA, MD 21046-3239
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0065430
MD
Other
Enumeration date
04/29/2014
Last updated
04/29/2014
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