Paraclete Care Inc | |
10801 Hickory Ridge Rd Suite 215 Columbia MD 21044-3869 | |
(410) 740-4411 | |
(410) 740-4421 |
Full Name | Paraclete Care Inc |
---|---|
Speciality | Internal Medicine |
Location | 10801 Hickory Ridge Rd, Columbia, Maryland |
Authorized Official Name and Position | Ikechukwu D Mbonu (PHYSICIAN) |
Authorized Official Contact | 4107404411 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Paraclete Care Inc 8600 Vintage Earth Path Laurel MD 20723-5879 Ph: (301) 483-0615 | Paraclete Care Inc 10801 Hickory Ridge Rd Suite 215 Columbia MD 21044-3869 Ph: (410) 740-4411 |
NPI Number | 1235309188 |
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Provider Enumeration Date | 03/06/2008 |
Last Update Date | 05/27/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1235309188 | NPI | - | NPPES |
415713300 | Medicaid | MD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | D0059649 (Maryland) | Primary |
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