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General NPI Number Information
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NPI Number | 1063456549
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Entity Type | Organization
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Legal Business Name | MEDSTAR PHYSICIAN PARTNERS
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 107 BEACON RD
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City | BALTIMORE
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State | MD
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Zip | 21220-3504
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Country | US
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Telephone | 410-686-9019
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Fax | 410-687-1975
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Provider Business Mailing Address
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Address Line | 107 BEACON RD
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City | BALTIMORE
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State | MD
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Zip | 21220-3504
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Country | US
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Telephone | 410-686-9019
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Fax | 410-687-1975
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Authorized Official
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Title or Position | INTERNAL MEDIACL DOCTOR
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Name | DR. PATRICIA RABELLO FREIRE AYRES
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Credential | MD
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Telephone | 410-686-9019
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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