| Olde Towne Primary Care Llc | |
|
317 E Diamond Ave C1 Gaithersburg MD 20877-3093 | |
| (240) 246-1111 | |
| Not Available |
| Full Name | Olde Towne Primary Care Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 317 E Diamond Ave, Gaithersburg, Maryland |
| Authorized Official Name and Position | Rasha Bafi Saleem (MANAGING OWNER) |
| Authorized Official Contact | 2023164407 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Olde Towne Primary Care Llc 317 E Diamond Ave C1 Gaithersburg MD 20877-3093 Ph: (240) 246-1111 | Olde Towne Primary Care Llc 317 E Diamond Ave C1 Gaithersburg MD 20877-3093 Ph: (240) 246-1111 |
| NPI Number | 1417315813 |
|---|---|
| Provider Enumeration Date | 02/01/2016 |
| Last Update Date | 10/25/2016 |
| Medicare PECOS PAC ID | 3476831314 |
|---|---|
| Medicare Enrollment ID | O20161028000496 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417315813 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Rasha B Saleem |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225132418 PECOS PAC ID: 8729139290 Enrollment ID: I20110404000564 |
| Provider Name | Ahmed M Saleem |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972675007 PECOS PAC ID: 6709982549 Enrollment ID: I20151028001535 |
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