Medical Legacy LLC

NPI #1114189453 in Randallstown, Maryland

Provider Information

NPI Number: 1114189453
Entity Type: Organization
Organization Name: Medical Legacy LLC
Primary Specialty: Clinic/Center - Primary Care
Enumeration Date: Jun 27, 2008
Last Updated: Jun 27, 2008

Practice Location

Address: 5310 OLD COURT RD
Address 2: SUITE 305
City: Randallstown
State: Maryland
ZIP Code: 21133-5243
Phone: (410) 655-7100

Authorized Official

Name: OLUTOYIN A OKUNOREN, RD
Title: PRACTICE COORDINATOR
Phone: (410) 655-7100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Primary Care — Primary Care	261QP2300X	Primary

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