Organization
FERGUSON CARE LLC
Active
Other names
American Family Care/Doctors Express
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LYNN MICHELLE GONDECK (MEDICAL ADMINISTRATOR)
(443) 244-0318
Entity
Organization
Contact information
Practice address
1860 REISTERSTOWN RD, PIKESVILLE, MD 21208-1335
(410) 484-4044
(410) 741-3797
Mailing address
4111 LOWER BECKLEYSVILLE RD STE C, HAMPSTEAD, MD 21074-2248
(410) 374-0808
(410) 741-3797
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
208D00000X
General Practice Physician
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
332900000X
Non-Pharmacy Dispensing Site
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
421373400
—
MD
Enumeration date
07/19/2010
Last updated
02/11/2020
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