PREMIER VASCULAR CENTER OF MARYLAND LLC NPI 1104335439

NPI Information

PREMIER VASCULAR CENTER OF MARYLAND LLC is a vascular surgery surgery in Towson, MD. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. PREMIER VASCULAR CENTER OF MARYLAND LLC NPI is 1104335439. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

7801 YORK ROAD
SUITE 240
TOWSON, MD
ZIP 21286
Phone: (410) 323-9214
Fax: (410) 323-9215

The provider's authorized official is Mouhamad O. Annous .
The authorized official title is President and has the following contact phone number (410) 323-9214.

The CLIA number assigned to this NPI record is 21D2167701 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/29/2017 and was last updated on 9/29/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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