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General NPI Number Information
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NPI Number | 1801391933
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Entity Type | Organization
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Legal Business Name | SOUTHERN MARYLAND NEPHROLOGY AND HYPERTENSION
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Dates
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Enumeration Date | 03/29/2018
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Last Update Date | 03/29/2018
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Provider Practice Location Address
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Address Line | 9131 PISCATAWAY RD STE 750
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City | CLINTON
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State | MD
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Zip | 20735-2581
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Country | US
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Telephone | 301-856-2810
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Fax |
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Provider Business Mailing Address
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Address Line | 1612 MAUD LN
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City | CROWNSVILLE
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State | MD
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Zip | 21032-1911
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ERIC ANTWI-DONKOR
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Credential | MD
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Telephone | 301-856-2810
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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