Organization
CENTRAL MARYLAND CARDIOLOGY, P.A.
Active
Organization
CENTRAL MARYLAND CARDIOLOGY, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JELLES N FONDA M.D. (PRESIDENT)
(410) 532-4205
Entity
Organization
Contact information
Practice address
5601 LOCH RAVEN BLVD, FOURTH FLOOR, BALTIMORE, MD 21239-2905
(410) 532-4205
(410) 532-4216
Mailing address
5601 LOCH RAVEN BLVD, FOURTH FLOOR, BALTIMORE, MD 21239-2905
(410) 532-4205
(410) 532-4216
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CN0298
PALMETTO GBA
MD
Enumeration date
06/30/2006
Last updated
08/22/2020
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