Maryland Healing Waters, LLC
NPI #1366739179 in Glen Burnie, Maryland
Provider Information
- NPI Number
- 1366739179
- Entity Type
- Organization
- Organization Name
- Maryland Healing Waters, LLC
- Primary Specialty
- Internal Medicine
- Enumeration Date
- Jun 30, 2011
- Last Updated
- May 17, 2024
Practice Location
- Address
- 1414 CRAIN HWY N STE 6A
- City
- Glen Burnie
- State
- Maryland
- ZIP Code
- 21061-9307
- Phone
- (410) 761-7901
Authorized Official
- Name
- DR. LAWRENCE VIDAVER, MD
- Title
- PHYSICIAN
- Phone
- (410) 761-7901
Specialties & Taxonomy Codes
| Specialty |
|---|
| Internal Medicine |
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