| Organization Name: | RICHARD BOMBACH |
| NPI Number: | 1306156591 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RICHARD BOMBACH (MD) |
| Mailing Address: | 10 Warren Road Suite 250 Cockeysville |
| State: | MD US |
| Postal Code: | 210302506 |
| Phone Number: | 4106830572 |
| Fax Number: | |
| NPI Enumeration Date: | 10/21/2010 |
| NPI Last Update Date: | 10/21/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | D34300 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |