| Medugo Health Care Llc | |
|
11204 Homestead Dr Upper Marlboro MD 20774-5760 | |
| (240) 486-7733 | |
| Not Available |
| Full Name | Medugo Health Care Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 11204 Homestead Dr, Upper Marlboro, Maryland |
| Authorized Official Name and Position | Lisa Medoh (CREDENTIALINGSPECIALIST) |
| Authorized Official Contact | 2404867733 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medugo Health Care Llc 11204 Homestead Dr Upper Marlboro MD 20774-5760 Ph: () - | Medugo Health Care Llc 11204 Homestead Dr Upper Marlboro MD 20774-5760 Ph: (240) 486-7733 |
| NPI Number | 1285343780 |
|---|---|
| Provider Enumeration Date | 11/23/2022 |
| Last Update Date | 11/23/2022 |
| Medicare PECOS PAC ID | 7618347899 |
|---|---|
| Medicare Enrollment ID | O20230104001586 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285343780 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Lisa Medoh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689039075 PECOS PAC ID: 6507126000 Enrollment ID: I20180201000121 |
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