Organization
MARYLAND HEALTHCARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG VICTOR IGOT TAMPUS MD (OWNER)
(410) 248-0661
Entity
Organization
Contact information
Practice address
4155 GLEN PARK RD, NOTTINGHAM, MD 21236-1019
(410) 248-0661
(443) 219-9771
Mailing address
216 OAK VALLEY DR, BEL AIR, MD 21014-5941
(410) 248-0661
(410) 248-9771
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0076580
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1356679138
—
VA
Enumeration date
12/09/2013
Last updated
11/15/2018
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