| Premier Health Express And Advanced Diagnostics Inc | |
|
9710 Patuxent Woods Dr Ste 200 Columbia MD 21046-3458 | |
| (443) 452-0739 | |
| (443) 200-0233 |
| Full Name | Premier Health Express And Advanced Diagnostics Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 9710 Patuxent Woods Dr Ste 200, Columbia, Maryland |
| Authorized Official Name and Position | Teresa Richardson (CHIEF OPERATIONS OFFICER) |
| Authorized Official Contact | 4438365376 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Health Express And Advanced Diagnostics Inc 9710 Patuxent Woods Dr Columbia MD 21046-1526 Ph: (443) 899-9525 | Premier Health Express And Advanced Diagnostics Inc 9710 Patuxent Woods Dr Ste 200 Columbia MD 21046-3458 Ph: (443) 452-0739 |
| NPI Number | 1144718792 |
|---|---|
| Provider Enumeration Date | 04/30/2018 |
| Last Update Date | 07/22/2024 |
| Medicare PECOS PAC ID | 3870857030 |
|---|---|
| Medicare Enrollment ID | O20180516001164 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144718792 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 261QU0200X | Clinic/center - Urgent Care | D0070766 (Maryland) | Primary |
| Provider Name | Ofundem Akoh Nokuri |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1487687141 PECOS PAC ID: 8426053455 Enrollment ID: I20070611000665 |
| Provider Name | Samuel Sunday Nokuri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730360587 PECOS PAC ID: 8921139908 Enrollment ID: I20101118000914 |
| Provider Name | Jo-ann Walter Middleton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245890177 PECOS PAC ID: 0941622401 Enrollment ID: I20200630000439 |
| Provider Name | Lamley Nakeya Armah Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811564594 PECOS PAC ID: 5698159630 Enrollment ID: I20220825001125 |
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