Organization
UNIVERSITY OF MARYLAND SPORTS MEDICINE AND WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAVONDA L WILLIAMS (CORPORATE DIRECTOR)
(667) 214-2507
Entity
Organization
Contact information
Practice address
5890 WATERLOO RD, COLUMBIA, MD 21045-2617
(667) 214-1333
Mailing address
PO BOX 64380, BALTIMORE, MD 21264-4380
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
12/19/2024
Last updated
12/19/2024
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