Organization
IMMUTECH-MIDATLANTIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN BUCKNER (CEO)
(410) 215-2596
Entity
Organization
Contact information
Practice address
1940 WINDER RD, WINDSOR MILL, MD 21244-1729
(410) 215-2596
Mailing address
1940 WINDER RD, WINDSOR MILL, MD 21244-1729
(410) 215-2596
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/22/2021
Last updated
07/21/2021
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