| Destiny Healthcare And Wellness Limited Liability Company | |
|
7060 Oakland Mills Rd Columbia MD 21046-1694 | |
| (410) 491-0962 | |
| Not Available |
| Full Name | Destiny Healthcare And Wellness Limited Liability Company |
|---|---|
| Speciality | Clinic/Center |
| Location | 7060 Oakland Mills Rd, Columbia, Maryland |
| Authorized Official Name and Position | Oludapo Raphael Eludoyin (CRNP) |
| Authorized Official Contact | 4104910962 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Destiny Healthcare And Wellness Limited Liability Company 6001 Charles Edward Ter Columbia MD 21045-5147 Ph: (410) 491-0962 | Destiny Healthcare And Wellness Limited Liability Company 7060 Oakland Mills Rd Columbia MD 21046-1694 Ph: (410) 491-0962 |
| NPI Number | 1356003743 |
|---|---|
| Provider Enumeration Date | 10/12/2021 |
| Last Update Date | 08/03/2023 |
| Medicare PECOS PAC ID | 2668829144 |
|---|---|
| Medicare Enrollment ID | O20240220000279 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356003743 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Oludapo Raphael Eludoyin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023644762 PECOS PAC ID: 0547589418 Enrollment ID: I20200618001393 |
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