| Shady Grove Family Health Care Inc | |
|
14800 Physicians Ln #131 Rockville MD 20850 | |
| (301) 251-9800 | |
| (301) 251-9802 |
| Full Name | Shady Grove Family Health Care Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 14800 Physicians Ln, Rockville, Maryland |
| Authorized Official Name and Position | Socrates Fotiu (PRESIDENT) |
| Authorized Official Contact | 3012519800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shady Grove Family Health Care Inc 14800 Physicians Ln #131 Rockville MD 20850 Ph: (301) 251-9800 | Shady Grove Family Health Care Inc 14800 Physicians Ln #131 Rockville MD 20850 Ph: (301) 251-9800 |
| NPI Number | 1255414389 |
|---|---|
| Provider Enumeration Date | 10/23/2006 |
| Last Update Date | 05/21/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255414389 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | D16065 (Maryland) | Primary |
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