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19856 Three Notch Rd Lexington Park MD 20653-3560 | |
| (301) 863-4031 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Student Health |
| Location | 19856 Three Notch Rd, Lexington Park, Maryland |
| Authorized Official Name and Position | Meenakshi Garg Brewster (HEALTH OFFICER) |
| Authorized Official Contact | 3014754317 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 316 Leonardtown MD 20650-0316 Ph: (301) 475-4330 | 19856 Three Notch Rd Lexington Park MD 20653-3560 Ph: (301) 863-4031 |
| NPI Number | 1154068138 |
|---|---|
| Provider Enumeration Date | 05/19/2022 |
| Last Update Date | 03/22/2023 |
| Certification Date | 03/22/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154068138 | NPI | - | NPPES |
| 987230200 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
| 261QS1000X | Clinic/center - Student Health | (* (Not Available)) | Primary |
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