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200 Cabin Branch Rd. Capital Heights MD 20743 | |
(443) 923-9200 | |
(443) 923-1875 |
Full Name | |
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Speciality | Clinic/center |
Location | 200 Cabin Branch Rd., Capital Heights, Maryland |
Authorized Official Name and Position | Mike J Neuman (VICE PRESIDENT FINANCE) |
Authorized Official Contact | 4439231810 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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P.o. Box 744865 Atlanta GA 30374 Ph: (443) 923-1886 | 200 Cabin Branch Rd. Capital Heights MD 20743 Ph: (443) 923-9200 |
NPI Number | 1831597871 |
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Provider Enumeration Date | 12/08/2014 |
Last Update Date | 09/16/2020 |
Certification Date | 09/16/2020 |
Identifier | Type | State | Issuer |
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1831597871 | NPI | - | NPPES |
1754815 01 | Medicaid | MD |