Healthcare Provider Details
I. General information
NPI: 1073027108
Provider Name (Legal Business Name): LOCKHEED MARTIN CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/28/2017
Last Update Date: 11/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
103 CHESAPEAKE PARK PLZ
MIDDLE RIVER MD
21220-4201
US
IV. Provider business mailing address
103 CHESAPEAKE PARK PLZ
MIDDLE RIVER MD
21220-4201
US
V. Phone/Fax
- Phone: 770-494-4131
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QC1800X |
| Taxonomy | Corporate Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARLEECE
S
BARBER
Title or Position: CHIEF MEDICAL OFFICER
Credential: MD
Phone: 301-548-2348