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General NPI Number Information
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NPI Number | 1194592220
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Entity Type | Organization
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Legal Business Name | PRIMARY CARE OF MARYLAND PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 12/08/2023
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 1300 YORK RD STE 190D
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City | LUTHERVILLE TIMONIUM
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State | MD
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Zip | 21093-6016
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Country | US
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Telephone | 443-288-5206
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Fax | 443-288-5205
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Provider Business Mailing Address
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Address Line | 1300 YORK RD STE 190D
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City | LUTHERVILLE TIMONIUM
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State | MD
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Zip | 21093-6016
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Country | US
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Telephone | 443-288-5206
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Fax | 443-288-5205
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Authorized Official
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Title or Position | OWNER
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Name | DR. GREG VICTOR I TAMPUS
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Credential | MD
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Telephone | 443-930-0161
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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