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15001 Shady Grove Rd 2nd Floor Rockville MD 20850 | |
| (301) 664-6464 | |
| (301) 963-0072 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 15001 Shady Grove Rd, Rockville, Maryland |
| Authorized Official Name and Position | Tracey Gersh (EVP/COO) |
| Authorized Official Contact | 3013552034 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
15001 Shady Grove Rd 2nd Floor Rockville MD 20850 Ph: (301) 664-6464 | 15001 Shady Grove Rd 2nd Floor Rockville MD 20850 Ph: (301) 664-6464 |
| NPI Number | 1326396896 |
|---|---|
| Provider Enumeration Date | 08/15/2012 |
| Last Update Date | 07/23/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326396896 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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