Organization
SUSQUEHANNA OB-GYN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA DODSON (CREDENTIALING MANAGER)
(443) 398-0189
Entity
Organization
Contact information
Practice address
520 UPPER CHESAPEAKE DR, BEL AIR, MD 21014-4339
(443) 643-4300
Mailing address
308 N UNION AVE, HAVRE DE GRACE, MD 21078-2825
(410) 939-3121
(410) 939-8278
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
05/05/2023
Last updated
08/06/2024
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