SearchMaryland183500000X

Santander Bornacelly, B652758014569

NPI 1699189118 · on the registry since 2014 · sole proprietor

Practice

Address
580 Wesel Blvd
Hagerstown, MD 21740
Phone
(301) 739-7230
Fax
(301) 733-1558

Registry record

Primary taxonomy
183500000X
183500000X
Licence states on file
MD
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2014-06-12

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Maryland