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General NPI Number Information
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NPI Number | 1366986739
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Entity Type | Organization
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Legal Business Name | MARYLAND MEDICAL CENTER, LLC
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Dates
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Enumeration Date | 12/05/2016
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Last Update Date | 12/05/2016
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Provider Practice Location Address
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Address Line | 8100 SANDPIPER CIR STE 100
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City | NOTTINGHAM
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State | MD
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Zip | 21236-5028
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Country | US
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Telephone | 410-529-8334
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Fax |
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Provider Business Mailing Address
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Address Line | 8100 SANDPIPER CIR STE 100
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City | NOTTINGHAM
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State | MD
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Zip | 21236-5028
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Country | US
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Telephone | 410-529-8334
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Fax |
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Authorized Official
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Title or Position | DIRECTOR, RESIDENT AGENT
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Name | DR. ANN C MORRILL
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Credential | M.D.
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Telephone | 410-529-8334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | D0034931
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License Number State | MD
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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 | D0034931
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License Number State | MD
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