MEDSPA M.D. LLC NPI 1871848614

NPI Information

MEDSPA M.D. LLC is a general practice in Baltimore, MD. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee MEDSPA M.D. LLC NPI is 1871848614. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

310 N EUTAW ST
BALTIMORE, MD
ZIP 21201-807
Phone: (410) 633-7721

The provider's authorized official is Susan Renee Clanzy .
The authorized official title is Ceo and has the following contact phone number (410) 446-2257.

The enumeration date for this NPI number is 7/18/2012 and was last updated on 7/18/2012.

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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