| J & G Family Practice Llc | |
|
6614 Windsor Mill Rd Gwynn Oak MD 21207-5381 | |
| (301) 404-1989 | |
| Not Available |
| Full Name | J & G Family Practice Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 6614 Windsor Mill Rd, Gwynn Oak, Maryland |
| Authorized Official Name and Position | Ngum Avwontom (PRESIDENT) |
| Authorized Official Contact | 3014041989 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| J & G Family Practice Llc 6614 Windsor Mill Rd Gwynn Oak MD 21207-5381 Ph: (301) 404-1989 | J & G Family Practice Llc 6614 Windsor Mill Rd Gwynn Oak MD 21207-5381 Ph: (301) 404-1989 |
| NPI Number | 1700526142 |
|---|---|
| Provider Enumeration Date | 04/01/2022 |
| Last Update Date | 04/01/2022 |
| Medicare PECOS PAC ID | 4880073915 |
|---|---|
| Medicare Enrollment ID | O20220621002091 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700526142 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Ngum Avwontom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972173904 PECOS PAC ID: 1658778881 Enrollment ID: I20210930000683 |
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