Organization
GERIATRIC MEDICAL ASSOCIATES
Active
Organization
GERIATRIC MEDICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA LARAY STANTON MSN (CRNP)
(410) 601-2246
Entity
Organization
Contact information
Practice address
2434 W BELVEDERE AVE, BALTIMORE, MD 21215-5202
(410) 601-2246
(410) 601-2924
Mailing address
2434 W BELVEDERE AVE, BALTIMORE, MD 21215-5202
(410) 601-2246
(410) 601-2924
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
R111052
MD
Other
Enumeration date
11/07/2005
Last updated
08/22/2020
Update your record
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