| Organization Name: | AGAS MEDICAL GROUP, LLC |
| NPI Number: | 1134461940 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KIMBERLY A. ANDERSON (PHYSICIAN) |
| Mailing Address: | 9811 Mallard Dr Suite # 213 Laurel |
| State: | MD US |
| Postal Code: | 207083143 |
| Phone Number: | 3016040562 |
| Fax Number: | 2408409533 |
| NPI Enumeration Date: | 03/19/2013 |
| NPI Last Update Date: | 03/19/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | D0034747 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |