| Maryland Primary Care And Wellness | |
|
14314 Old Marlboro Pike Upper Marlboro MD 20772-2840 | |
| (301) 627-3500 | |
| (301) 627-1634 |
| Full Name | Maryland Primary Care And Wellness |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 14314 Old Marlboro Pike, Upper Marlboro, Maryland |
| Authorized Official Name and Position | Albert Enow Enow Takem (OWNER) |
| Authorized Official Contact | 2404086286 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Maryland Primary Care And Wellness 7100 Longwood Dr Bethesda MD 20817-2120 Ph: (240) 408-6286 | Maryland Primary Care And Wellness 14314 Old Marlboro Pike Upper Marlboro MD 20772-2840 Ph: (301) 627-3500 |
| NPI Number | 1871198671 |
|---|---|
| Provider Enumeration Date | 12/01/2020 |
| Last Update Date | 12/01/2020 |
| Certification Date | 11/28/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871198671 | NPI | - | NPPES |
| 924025000 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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