| Lj Medical Llc | |
|
6244 Montrose Rd Rockville MD 20852-4119 | |
| (301) 917-4139 | |
| (301) 338-6463 |
| Full Name | Lj Medical Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 6244 Montrose Rd, Rockville, Maryland |
| Authorized Official Name and Position | Malvis Tamon (CEO) |
| Authorized Official Contact | 2404263316 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lj Medical Llc 632 Pelican Ave Gaithersburg MD 20877-2908 Ph: (240) 426-3316 | Lj Medical Llc 6244 Montrose Rd Rockville MD 20852-4119 Ph: (301) 917-4139 |
| NPI Number | 1750993663 |
|---|---|
| Provider Enumeration Date | 08/21/2020 |
| Last Update Date | 05/12/2021 |
| Medicare PECOS PAC ID | 2769893767 |
|---|---|
| Medicare Enrollment ID | O20201124000025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750993663 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Malvis N Tamon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679059794 PECOS PAC ID: 1153732649 Enrollment ID: I20201207000174 |
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