Organization
BRAVO HEALTH ADVANCED CARE CENTER, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIRK WALES MD (PRESIDENT)
(615) 236-6162
Entity
Organization
Contact information
Practice address
312 MARTIN LUTHER KING JR BLVD, BALTIMORE, MD 21201-1221
(443) 278-7001
Mailing address
312 MARTIN LUTHER KING JR BLVD STE 200, BALTIMORE, MD 21201-1221
(443) 278-7001
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
10/05/2012
Last updated
04/13/2018
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