| Elite Primary Care Group Llc | |
|
801 Toll House Ave Ste D3 Frederick MD 21701-6112 | |
| (405) 796-8367 | |
| (405) 716-4808 |
| Full Name | Elite Primary Care Group Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 801 Toll House Ave Ste D3, Frederick, Maryland |
| Authorized Official Name and Position | Fahima Azizi (CO-ONWER) |
| Authorized Official Contact | 4057968367 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Primary Care Group Llc 801 Toll House Ave Ste D3 Frederick MD 21701-6112 Ph: (405) 796-8367 | Elite Primary Care Group Llc 801 Toll House Ave Ste D3 Frederick MD 21701-6112 Ph: (405) 796-8367 |
| NPI Number | 1174112734 |
|---|---|
| Provider Enumeration Date | 01/18/2021 |
| Last Update Date | 01/18/2021 |
| Medicare PECOS PAC ID | 1850706706 |
|---|---|
| Medicare Enrollment ID | O20210226001284 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174112734 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Fahima Azizi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1477865814 PECOS PAC ID: 9234363581 Enrollment ID: I20160419000678 |
| Provider Name | Rita Kapoor |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1699199281 PECOS PAC ID: 7517286628 Enrollment ID: I20161018000497 |
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