| Lifetouch Clinical Consultants,llc | |
|
4512 Doctor Beans Legacy Cir Bowie MD 20720-6384 | |
| (202) 257-2130 | |
| Not Available |
| Full Name | Lifetouch Clinical Consultants,llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 4512 Doctor Beans Legacy Cir, Bowie, Maryland |
| Authorized Official Name and Position | Esabella Mah Tebid Mbah (FNP-BC) |
| Authorized Official Contact | 2022572130 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifetouch Clinical Consultants,llc 4512 Doctor Beans Legacy Cir Bowie MD 20720-6384 Ph: (202) 257-2130 | Lifetouch Clinical Consultants,llc 4512 Doctor Beans Legacy Cir Bowie MD 20720-6384 Ph: (202) 257-2130 |
| NPI Number | 1417492141 |
|---|---|
| Provider Enumeration Date | 01/04/2017 |
| Last Update Date | 01/23/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417492141 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | R174293 (Maryland) | Primary |
| 261QP2300X | Clinic/center - Primary Care | RN1009165 (District Of Columbia) | Secondary |
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