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General NPI Number Information
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NPI Number | 1356983811
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Entity Type | Organization
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Legal Business Name | FRONTLINE PHYSICIANS CORP
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Dates
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Enumeration Date | 10/16/2019
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Last Update Date | 10/16/2019
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Provider Practice Location Address
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Address Line | 1314 BEDFORD AVE
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City | PIKESVILLE
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State | MD
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Zip | 21208-6604
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Country | US
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Telephone | 610-400-4253
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Fax |
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Provider Business Mailing Address
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Address Line | 3119 ROBERTS LNDG
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City | FINKSBURG
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State | MD
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Zip | 21048-1352
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Country | US
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Telephone | 610-400-4253
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KRISTIAN LASZLO SANDOR
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Credential | MD, CWS-P
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Telephone | 610-400-4253
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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