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General NPI Number Information
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NPI Number | 1174387286
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Entity Type | Organization
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Legal Business Name | SYNERGY MEDICAL GROUP LLC
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Dates
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Enumeration Date | 02/08/2024
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 8720 EMGE RD
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City | PARKVILLE
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State | MD
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Zip | 21234-3504
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Country | US
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Telephone | 410-870-9380
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Fax |
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Provider Business Mailing Address
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Address Line | 1205 YORK RD
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City | LUTHERVILLE
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State | MD
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Zip | 21093-6210
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KAMAL SALAH H SEWARALTHAHAB
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Credential |
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Telephone | 443-325-0031
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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