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General NPI Number Information
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NPI Number | 1225922362
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Entity Type | Organization
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Legal Business Name | QUARRY PREMIER MEDICINE LLC
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Dates
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Enumeration Date | 06/04/2025
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 2700 QUARRY LAKE DR STE 200
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City | BALTIMORE
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State | MD
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Zip | 21209-3762
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Country | US
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Telephone | 410-415-5814
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Fax |
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Provider Business Mailing Address
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Address Line | 2700 QUARRY LAKE DR STE 200
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City | BALTIMORE
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State | MD
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Zip | 21209-3762
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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 | DR. ERICA JOY DEWITT
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Credential | MD
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Telephone | 410-608-4612
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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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 | 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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