Organization
NORTHWEST BALTIMORE RADIATION THERAPY REGIONAL CENTER, LLC
Active
Other names
Lifebridge Health Radiation Oncology Center at Owing Mills
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID N.T. WATSON (CFO)
(239) 931-7342
Entity
Organization
Contact information
Practice address
25 CROSSROADS DR, SUITE110, OWINGS MILLS, MD 21117-5421
(410) 998-9993
(410) 998-4242
Mailing address
2234 COLONIAL BLVD, FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CK7262
RAILROAD MEDICARE
MD
Enumeration date
02/24/2006
Last updated
01/18/2008
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