Healthcare Provider Details

I. General information

NPI: 1093831158
Provider Name (Legal Business Name): MBS MEDICINE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9403 HARFORD RD SUITE 7
BALTIMORE MD
21234-3123
US

IV. Provider business mailing address

9403 HARFORD RD SUITE 7
BALTIMORE MD
21234-3123
US

V. Phone/Fax

Practice location:
  • Phone: 410-882-4852
  • Fax: 410-882-4853
Mailing address:
  • Phone: 410-882-4852
  • Fax: 410-882-4853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number StateMD

VIII. Authorized Official

Name: MR. DOMENIC J. THOMAS
Title or Position: CEO
Credential: L.AC.
Phone: 410-882-4852