Organization
HEALTHY SHAPES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT CADOGAN MD (SOLE PROPRIETOR)
(410) 300-4545
Entity
Organization
Contact information
Practice address
10760 HICKORY RIDGE RD, SUITE 125, COLUMBIA, MD 21044-3682
(410) 300-4545
(443) 283-4477
Mailing address
PO BOX 2727, COLUMBIA, MD 21045-1727
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0051318
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D0051318
STATE LICENSE
MD
Enumeration date
05/20/2011
Last updated
05/20/2011
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