Organization
ROSEDALE PRIMARY CARE PHYSICIAN, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. XIAOFEI LI (RESIDENT AGENT)
(410) 218-5523
Entity
Organization
Contact information
Practice address
19 FONTANA LN, SUITE 108-110, ROSEDALE, MD 21237-3047
(410) 218-5523
Mailing address
540 MONTCLAIR CT, PARKTON, MD 21120-9801
(410) 218-5523
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
D0076990
MD
Other
Enumeration date
05/25/2016
Last updated
05/25/2016
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