Organization
LGM HEALTHCARE SERVICES & AESTHETICS MEDICINE
Active
Other names
LGM Healthcare Services
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ILA MELVIN FNP-BC , NP-C (FAMILY NURSE PRACTITONER)
(410) 661-9020
Entity
Organization
Contact information
Practice address
7850 ROSSVILLE BLVD STE 210, NOTTINGHAM, MD 21236-3934
(443) 858-6828
Mailing address
7850 ROSSVILLE BLVD STE 210, NOTTINGHAM, MD 21236-3934
(410) 661-9020
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
444289000
—
MD
Enumeration date
03/29/2018
Last updated
01/19/2021
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