NPI 1114189453

Medical Legacy LLC

Organisation Primary Care Clinic/Center Randallstown, MD

Practice location

Address: 5310 Old Court Rd Suite 305, Randallstown, MD 21133-5243
Phone: (410) 655-7100
Fax: (410) 655-7917
Mailing address: 5310 Old Court Rd Suite 305, Randallstown, MA 21133

Authorised official

Name: Olutoyin a Okunoren
Title: Practice Coordinator
Phone: (410) 655-7100

Registered specialties

Primary Care Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QP2300X Licence D0023724 (MD)

Other Clinic/Center providers in Maryland →

Registry record

NPI: 1114189453
Entity type: Organization
NPI issued: 27 Jun 2008
Record last updated: 27 Jun 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.