| Matobi Family Healthcare,llc | |
|
7350 Van Dusen Rd Ste 340 Laurel MD 20707-5264 | |
| (240) 423-2043 | |
| Not Available |
| Full Name | Matobi Family Healthcare,llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 7350 Van Dusen Rd Ste 340, Laurel, Maryland |
| Authorized Official Name and Position | Sussan Ononaku (CRNP) |
| Authorized Official Contact | 2404232043 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Matobi Family Healthcare,llc 12203 Loch Lynn Ct Laurel MD 20708-2409 Ph: (240) 423-2043 | Matobi Family Healthcare,llc 7350 Van Dusen Rd Ste 340 Laurel MD 20707-5264 Ph: (240) 423-2043 |
| NPI Number | 1831750546 |
|---|---|
| Provider Enumeration Date | 06/24/2019 |
| Last Update Date | 06/24/2019 |
| Medicare PECOS PAC ID | 8628309762 |
|---|---|
| Medicare Enrollment ID | O20191003003378 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831750546 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Sussan Ononaku |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982029203 PECOS PAC ID: 0345473799 Enrollment ID: I20140509000429 |
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