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General NPI Number Information
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NPI Number | 1497397400
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Entity Type | Organization
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Legal Business Name | UPLIFT PATIENT CARE
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Dates
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Enumeration Date | 10/10/2019
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Last Update Date | 10/10/2019
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Provider Practice Location Address
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Address Line | 516 N ROLLING RD STE 203
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City | CATONSVILLE
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State | MD
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Zip | 21228-4187
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Country | US
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Telephone | 410-788-1540
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6396
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City | LARGO
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State | MD
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Zip | 20792-6396
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Country | US
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Telephone | 410-788-1540
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Fax |
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Authorized Official
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Title or Position | CONSULTANT
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Name | DAN AUSTIN
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Credential |
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Telephone | 410-788-1540
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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