| Integrare Health Maryland | |
|
9500 Medical Center Dr Ste 474 Largo MD 20774-3725 | |
| (202) 796-5000 | |
| Not Available |
| Full Name | Integrare Health Maryland |
|---|---|
| Speciality | Internal Medicine |
| Location | 9500 Medical Center Dr Ste 474, Largo, Maryland |
| Authorized Official Name and Position | Charletta Washington (MANAGER) |
| Authorized Official Contact | 2024122730 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrare Health Maryland 9500 Medical Center Dr Ste 104 Largo MD 20774-3703 Ph: (202) 796-5000 | Integrare Health Maryland 9500 Medical Center Dr Ste 474 Largo MD 20774-3725 Ph: (202) 796-5000 |
| NPI Number | 1194496703 |
|---|---|
| Provider Enumeration Date | 09/23/2021 |
| Last Update Date | 10/20/2021 |
| Medicare PECOS PAC ID | 6204218969 |
|---|---|
| Medicare Enrollment ID | O20220728000923 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194496703 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Chinyenum Otuya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376105882 PECOS PAC ID: 2769883115 Enrollment ID: I20210623002267 |
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