Atofom Llc | |
2108 Woodvale Ln Bowie MD 20721-4104 | |
(301) 675-9644 | |
Not Available |
Full Name | Atofom Llc |
---|---|
Speciality | Community/Behavioral Health |
Location | 2108 Woodvale Ln, Bowie, Maryland |
Authorized Official Name and Position | Temitope Adebusoye (OWNER) |
Authorized Official Contact | 3016759644 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Atofom Llc 2108 Woodvale Ln Bowie MD 20721-4104 Ph: (301) 675-9644 | Atofom Llc 2108 Woodvale Ln Bowie MD 20721-4104 Ph: (301) 675-9644 |
NPI Number | 1083339733 |
---|---|
Provider Enumeration Date | 10/05/2022 |
Last Update Date | 10/05/2022 |
Certification Date | 10/05/2022 |
Medicare PECOS PAC ID | 9830569706 |
---|---|
Medicare Enrollment ID | O20230110003226 |
Identifier | Type | State | Issuer |
---|---|---|---|
1083339733 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Provider Name | Temitope Adebusoye |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1346917200 PECOS PAC ID: 9830574904 Enrollment ID: I20220912000292 |
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