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General NPI Number Information
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NPI Number | 1598199093
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Entity Type | Organization
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Legal Business Name | MEDSTAR URGENT CARE
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Dates
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Enumeration Date | 09/03/2013
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Last Update Date | 09/03/2013
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Provider Practice Location Address
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Address Line | 8605 RIDGELY'S CHOICE DRIVE
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City | BALTIMORE
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State | MD
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Zip | 21236
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Country | US
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Telephone | 410-248-2310
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Fax | 410-248-2311
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Provider Business Mailing Address
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Address Line | 8605 RIDGELY'S CHOICE DRIVE
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City | BALTIMORE
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State | MD
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Zip | 21236
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Country | US
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Telephone | 410-248-2310
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Fax | 410-248-2311
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Authorized Official
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Title or Position | CORPORATE VICE PRESIDENT
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Name | MR. DEBORAH KUCHKA-CRAIG
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Credential |
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Telephone | 410-772-6827
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 03695726
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License Number State | MD
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