316th Medgrp-Malcolm Grow

NPI #1215994660 in Jb Andrews, Maryland

Provider Information

NPI Number: 1215994660
Entity Type: Organization
Organization Name: 316th Medgrp-Malcolm Grow
Subpart: Yes (part of a larger organization)
Parent Organization: 316TH MEDGRP-MALCOLM GROW
Primary Specialty: Clinic/Center - Military and U.S. Coast Guard Ambulatory Procedure
Enumeration Date: Apr 28, 2006
Last Updated: Mar 12, 2025

Practice Location

Address: 1060 W PERIMETER RD
City: Jb Andrews
State: Maryland
ZIP Code: 20762-6602
Phone: (240) 857-8658

Authorized Official

Name: WILLIAM MICHAEL CONDON
Title: DHA FINANCIAL MANAGER
Phone: (240) 401-3643

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Military/U.S. Coast Guard Outpatient — Military/U.S. Coast Guard Outpatient	261QM1100X
Clinic/Center - Military and U.S. Coast Guard Ambulatory Procedure — Military and U.S. Coast Guard Ambulatory Procedure	261QM1101X	Primary

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