| Outreach Md Llc | |
|
4201 Northview Dr Suite 501 Bowie MD 20716-2604 | |
| (410) 220-1111 | |
| Not Available |
| Full Name | Outreach Md Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 4201 Northview Dr, Bowie, Maryland |
| Authorized Official Name and Position | Ehsan Abdeshahian (MEDICAL DIRECTOR) |
| Authorized Official Contact | 4053060384 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Outreach Md Llc 2124 4th Ave S Birmingham AL 35233-2204 Ph: (205) 279-8981 | Outreach Md Llc 4201 Northview Dr Suite 501 Bowie MD 20716-2604 Ph: (410) 220-1111 |
| NPI Number | 1235584384 |
|---|---|
| Provider Enumeration Date | 04/26/2016 |
| Last Update Date | 08/18/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235584384 | NPI | - | NPPES |
| 0714704 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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