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General NPI Number Information
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NPI Number | 1124783907
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Entity Type | Organization
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Legal Business Name | VICTORY MEDICAL CENTER
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Dates
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Enumeration Date | 11/05/2021
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Last Update Date | 11/05/2021
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Provider Practice Location Address
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Address Line | 1101 N POINT BLVD STE 110
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City | BALTIMORE
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State | MD
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Zip | 21224-3417
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Country | US
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Telephone | 410-624-5125
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Fax | 410-624-5126
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Provider Business Mailing Address
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Address Line | 1101 N POINT BLVD STE 110
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City | BALTIMORE
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State | MD
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Zip | 21224-3417
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Country | US
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Telephone | 410-624-5125
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Fax | 410-624-5126
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Authorized Official
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Title or Position | NURSE PRACTIONER
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Name | VICTORIA ADARAMAJA
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Credential | NP
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Telephone | 443-449-3003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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