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General NPI Number Information
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NPI Number | 1063454783
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Entity Type | Organization
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Legal Business Name | 21ST CENTURY ONCOLOGY OF HARFORD COUNTY MARYLAND, LLC
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Dates
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Enumeration Date | 06/11/2006
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Last Update Date | 02/20/2008
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Provider Practice Location Address
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Address Line | 1200 BRASS MILL RD SUITE E
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City | BELCAMP
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State | MD
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Zip | 21017-1217
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Country | US
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Telephone | 410-272-9224
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Fax | 410-575-7951
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Provider Business Mailing Address
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Address Line | 2234 COLONIAL BLVD
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City | FORT MYERS
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State | FL
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Zip | 33907-1412
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Country | US
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Telephone | 239-931-7342
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Fax | 239-931-7385
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Authorized Official
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Title or Position | CFO
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Name | DAVID N.T. WATSON
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Credential |
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Telephone | 239-931-7281
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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