Premier Senior Care | |
6935 Wisconsin Ave Ste 314 Chevy Chase MD 20815-6112 | |
(301) 530-3237 | |
(301) 907-4590 |
Full Name | Premier Senior Care |
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Speciality | Internal Medicine |
Location | 6935 Wisconsin Ave Ste 314, Chevy Chase, Maryland |
Authorized Official Name and Position | Roy Fried (PHYSICIAN OWNER) |
Authorized Official Contact | 3015303237 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Premier Senior Care 6935 Wisconsin Ave Ste 314 Chevy Chase MD 20815-6112 Ph: (301) 530-3237 | Premier Senior Care 6935 Wisconsin Ave Ste 314 Chevy Chase MD 20815-6112 Ph: (301) 530-3237 |
NPI Number | 1194054171 |
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Provider Enumeration Date | 12/21/2009 |
Last Update Date | 10/25/2022 |
Medicare PECOS PAC ID | 4385770783 |
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Medicare Enrollment ID | O20100324000957 |
Identifier | Type | State | Issuer |
---|---|---|---|
1194054171 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RG0300X | Internal Medicine - Geriatric Medicine | D34590 (Maryland) | Primary |
Provider Name | Wendy W De Silva |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1649200825 PECOS PAC ID: 1355385949 Enrollment ID: I20070222000336 |
Provider Name | Roy E Fried |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1881626059 PECOS PAC ID: 0143396762 Enrollment ID: I20080905000273 |
Provider Name | Gary B Wilks |
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Provider Type | Practitioner - Geriatric Medicine |
Provider Identifiers | NPI Number: 1902821713 PECOS PAC ID: 1759464605 Enrollment ID: I20081001000012 |
Provider Name | Angela L Novas |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1841680915 PECOS PAC ID: 9931426418 Enrollment ID: I20150820010488 |
Provider Name | Cheryl A O'neil |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1982084679 PECOS PAC ID: 5496056236 Enrollment ID: I20160627001295 |
Provider Name | Amy Leslie Fox |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1992097265 PECOS PAC ID: 7416125851 Enrollment ID: I20170110000112 |
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