Lifetouch Family Clinic Llc | |
9801 Greenbelt Rd Ste 103 Lanham MD 20706-6204 | |
(202) 257-2130 | |
Not Available |
Full Name | Lifetouch Family Clinic Llc |
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Speciality | Nurse Practitioner |
Location | 9801 Greenbelt Rd Ste 103, Lanham, Maryland |
Authorized Official Name and Position | Esabella Tebid Mbah (NP) |
Authorized Official Contact | 2022572130 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Lifetouch Family Clinic Llc 9801 Greenbelt Rd Ste 104 Lanham MD 20706-6204 Ph: () - | Lifetouch Family Clinic Llc 9801 Greenbelt Rd Ste 103 Lanham MD 20706-6204 Ph: (202) 257-2130 |
NPI Number | 1023729076 |
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Provider Enumeration Date | 12/12/2022 |
Last Update Date | 03/14/2024 |
Medicare PECOS PAC ID | 8820461031 |
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Medicare Enrollment ID | O20230308001472 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023729076 | NPI | - | NPPES |
R174293 | Medicaid | MD |
Provider Name | Esabella Mah Tebid Mbah |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1730511981 PECOS PAC ID: 0547544926 Enrollment ID: I20170302001733 |
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