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General NPI Number Information
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NPI Number | 1306186911
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Entity Type | Organization
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Legal Business Name | HOME PRIMARY CARE, LLC
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Dates
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Enumeration Date | 02/19/2013
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Last Update Date | 07/13/2022
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Provider Practice Location Address
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Address Line | 6940 CLEARWIND COURT
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City | BALTIMORE
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State | MD
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Zip | 21209
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Country | US
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Telephone | 410-205-6525
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Fax | 410-602-5303
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Provider Business Mailing Address
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Address Line | 6940 CLEARWIND COURT
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City | BALTIMORE
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State | MD
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Zip | 21209
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Country | US
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Telephone | 410-205-6525
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Fax | 410-602-5303
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MR. ALBERT FUZAYL
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Credential | PA-C
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Telephone | 410-205-6525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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