| Md Medical And Wellness Center | |
|
4000 Mitchellville Rd Ste A308 Bowie MD 20716-3135 | |
| (301) 808-0341 | |
| (301) 263-6860 |
| Full Name | Md Medical And Wellness Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 4000 Mitchellville Rd Ste A308, Bowie, Maryland |
| Authorized Official Name and Position | Miriam D. Martin (MEDICAL DIRECTOR) |
| Authorized Official Contact | 3018080341 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Md Medical And Wellness Center 4000 Mitchellville Rd Ste A308 Bowie MD 20716-3135 Ph: (301) 808-0341 | Md Medical And Wellness Center 4000 Mitchellville Rd Ste A308 Bowie MD 20716-3135 Ph: (301) 808-0341 |
| NPI Number | 1376180596 |
|---|---|
| Provider Enumeration Date | 12/06/2019 |
| Last Update Date | 12/06/2019 |
| Medicare PECOS PAC ID | 4183050339 |
|---|---|
| Medicare Enrollment ID | O20200206000066 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376180596 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Miriam Dalton Martin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1154348787 PECOS PAC ID: 0941100218 Enrollment ID: I20071011000684 |
| Provider Name | Jacqueline Newsome-williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366883621 PECOS PAC ID: 0143552570 Enrollment ID: I20191104002340 |
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