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General NPI Number Information
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NPI Number | 1740798412
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Entity Type | Organization
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Legal Business Name | VICTORY MEDICAL CENTER
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Dates
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Enumeration Date | 01/17/2018
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Last Update Date | 04/27/2018
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Provider Practice Location Address
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Address Line | 1101 N POINT BLVD STE 110
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City | BALTIMORE
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State | MD
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Zip | 21224-3417
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Country | US
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Telephone | 443-449-3003
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Fax |
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Provider Business Mailing Address
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Address Line | 1101 N POINT BLVD STE 110
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City | BALTIMORE
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State | MD
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Zip | 21224-3417
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Country | US
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Telephone | 443-449-3003
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | VICTORIA ADARAMAJA
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Credential | DNP
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Telephone | 443-449-3003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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