| Calvary Psychiatric Services | |
|
1450 Mercantile Ln Ste 243 Upper Marlboro MD 20774-5464 | |
| (240) 761-3886 | |
| Not Available |
| Full Name | Calvary Psychiatric Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 1450 Mercantile Ln Ste 243, Upper Marlboro, Maryland |
| Authorized Official Name and Position | Obinna Chukwuebuka Okonkwo (CEO) |
| Authorized Official Contact | 2407613886 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Calvary Psychiatric Services 10609 Broadleaf Dr Upper Marlboro MD 20774-2369 Ph: (240) 761-3886 | Calvary Psychiatric Services 1450 Mercantile Ln Ste 243 Upper Marlboro MD 20774-5464 Ph: (240) 761-3886 |
| NPI Number | 1174263222 |
|---|---|
| Provider Enumeration Date | 03/29/2022 |
| Last Update Date | 05/30/2022 |
| Certification Date | 05/30/2022 |
| Medicare PECOS PAC ID | 3173910544 |
|---|---|
| Medicare Enrollment ID | O20220504000431 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174263222 | NPI | - | NPPES |
| Provider Name | Obinna Chukwuebuka Okonkwo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235893363 PECOS PAC ID: 4981098340 Enrollment ID: I20220504000573 |
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