Organization
ANTARES MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CORNELIOUS MUSARA MD (OWNER)
(410) 768-0074
Entity
Organization
Contact information
Practice address
7671 QUARTERFIELD ROAD, SUITE 302, GLEN BURNIE, MD 21061
(410) 768-0074
(410) 768-0075
Mailing address
PO BOX 696, FULTON, MD 20759-0696
(410) 768-0074
(410) 768-0075
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
D59105
MD
Other
Enumeration date
12/20/2011
Last updated
08/25/2020
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