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General NPI Number Information
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NPI Number | 1295127660
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Entity Type | Organization
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Legal Business Name | THE WELLWORKPLACE
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Dates
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Enumeration Date | 02/23/2015
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Last Update Date | 02/23/2015
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Provider Practice Location Address
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Address Line | 7543 MAIN ST 2ND FLOOR
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City | SYKESVILLE
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State | MD
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Zip | 21784-7389
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Country | US
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Telephone | 410-795-7579
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Fax |
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Provider Business Mailing Address
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Address Line | 7543 MAIN ST 2ND FLOOR
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City | SYKESVILLE
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State | MD
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Zip | 21784-7389
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Country | US
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Telephone | 410-795-7579
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT OF OPERATIONS
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Name | BONNIE MONROE
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Credential |
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Telephone | 410-795-7579
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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 | D0040085
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License Number State | MD
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