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General NPI Number Information
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NPI Number | 1740424092
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Entity Type | Organization
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Legal Business Name | COASTAL MEDICAL CENTER PA C/O PAUL D BRUNS, JR, MD
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Dates
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Enumeration Date | 04/29/2009
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Last Update Date | 04/29/2009
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Provider Practice Location Address
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Address Line | 6300 COASTAL HWY
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City | OCEAN CITY
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State | MD
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Zip | 21842-7312
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Country | US
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Telephone | 410-726-5540
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Fax |
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Provider Business Mailing Address
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Address Line | 12470 WENDELL HOLMES RD
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City | HERNDON
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State | VA
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Zip | 20171-2461
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Country | US
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Telephone | 410-726-5540
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | PAUL D BRUNS JR.
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Credential | M.D.
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Telephone | 410-726-5540
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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 | D0023377
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License Number State | MD
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