Healthcare Provider Details

I. General information

NPI: 1720766538
Provider Name (Legal Business Name): BHW ADDICTION MEDICINE GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2023
Last Update Date: 07/11/2023
Certification Date: 07/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 GARRISON BLVD STE 100A
BALTIMORE MD
21216-2308
US

IV. Provider business mailing address

2300 GARRISON BLVD STE 100A
BALTIMORE MD
21216-2308
US

V. Phone/Fax

Practice location:
  • Phone: 443-762-5343
  • Fax: 833-258-3941
Mailing address:
  • Phone: 443-762-5343
  • Fax: 833-258-3941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: AMARIS MURRAY
Title or Position: OWNER
Credential: CRNP
Phone: 443-762-5343