| Bali Healthcare, Inc. | |
|
1841 Brightseat Rd Landover MD 20785-4250 | |
| (301) 364-3300 | |
| (301) 364-3305 |
| Full Name | Bali Healthcare, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 1841 Brightseat Rd, Landover, Maryland |
| Authorized Official Name and Position | Alfred Sibedwo (PRESIDENT/CEO) |
| Authorized Official Contact | 3013643300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bali Healthcare, Inc. Po Box 6854 Largo MD 20792-6854 Ph: (301) 364-3300 | Bali Healthcare, Inc. 1841 Brightseat Rd Landover MD 20785-4250 Ph: (301) 364-3300 |
| NPI Number | 1699105395 |
|---|---|
| Provider Enumeration Date | 11/15/2013 |
| Last Update Date | 11/19/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699105395 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | D0052015 (Maryland) | Primary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | D0052015 (Maryland) | Secondary |
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