| Primal Health Family Practice | |
|
3261 Old Washington Rd Ste 2020 Waldorf MD 20602-3231 | |
| (240) 923-0614 | |
| Not Available |
| Full Name | Primal Health Family Practice |
|---|---|
| Speciality | Nurse Practitioner - Family |
| Location | 3261 Old Washington Rd Ste 2020, Waldorf, Maryland |
| Authorized Official Name and Position | Nnegadi Tataw (CEO) |
| Authorized Official Contact | 2404252762 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Primal Health Family Practice 3261 Old Washington Rd Ste 2020 Waldorf MD 20602-3231 Ph: (240) 425-2762 | Primal Health Family Practice 3261 Old Washington Rd Ste 2020 Waldorf MD 20602-3231 Ph: (240) 923-0614 |
| NPI Number | 1013470772 |
|---|---|
| Provider Enumeration Date | 04/10/2019 |
| Last Update Date | 10/31/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013470772 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Primary |
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