South River Primary Care LLC

NPI #1154548303 in Edgewater, Maryland

Provider Information

NPI Number
1154548303
Entity Type
Organization
Organization Name
South River Primary Care LLC
Primary Specialty
Family Medicine
Enumeration Date
Apr 19, 2007
Last Updated
Jul 29, 2009

Practice Location

Address
3168 BRAVERTON ST
Address 2
SUITE 330
ZIP Code
21037-2674
Phone
(410) 956-7830

Authorized Official

Name
DR. TIMOTHY PAUL FRY, D.O.
Title
OWNER
Phone
(410) 956-7830

Specialties & Taxonomy Codes

Specialty
Family Medicine

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