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General NPI Number Information
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NPI Number | 1194317941
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Entity Type | Organization
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Legal Business Name | MARYLAND ONCOLOGY HEMATOLOGY, P.A.
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Dates
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Enumeration Date | 02/03/2021
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Last Update Date | 02/03/2021
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Provider Practice Location Address
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Address Line | 9905 MEDICAL CENTER DR STE 200
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City | ROCKVILLE
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State | MD
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Zip | 20850-6535
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Country | US
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Telephone | 301-424-6231
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Fax |
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Provider Business Mailing Address
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Address Line | 11720 BELTSVILLE DR STE 300
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City | BELTSVILLE
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State | MD
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Zip | 20705-3119
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Country | US
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Telephone | 410-241-1657
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Fax |
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Authorized Official
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Title or Position | PRACTICE DIRECTOR
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Name | LISA TALBOTT
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Credential |
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Telephone | 410-952-8421
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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