Individual
MARY BETH GROTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8105 RITCHIE HIGHWAY, PASADENA, MD 21122
(443) 573-0564
Mailing address
5000 COX RD, GLEN ALLEN, VA 23060-9263
(804) 968-5700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
H0054025
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
421101400
—
MD
Enumeration date
07/02/2006
Last updated
06/23/2021
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