University Of Maryland Sports Medicine And Wellness, LLC
Family Medicine, Sports Medicine in Columbia, MD. Organization (NPI-2).
NPI number1750199097
StatusActive
Last updated in NPPESDec 19, 2024
Details
- NPI
- 1750199097
- Entity type
- Organization (NPI-2)
- Legal business name
- University Of Maryland Sports Medicine And Wellness, LLC
- Organization subpart
- No
- Enumeration date
- Dec 19, 2024
- Certification date
- Dec 19, 2024
- Last updated
- Dec 19, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207QS0010X | Family Medicine, Sports Medicine | – | – | Yes |
Practice location
5900 Waterloo RdColumbia, MD 21045-2639
Phone 667-214-1333
Mailing address
Po Box 64380Baltimore, MD 21264-4380
Authorized official
Shavonda L Williams
Corporate Director
6672142507
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