| Toseg Medical Center, Llc | |
|
19650 Club House Rd Ste 104 Gaithersburg MD 20886-3039 | |
| (410) 970-2640 | |
| Not Available |
| Full Name | Toseg Medical Center, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 19650 Club House Rd Ste 104, Gaithersburg, Maryland |
| Authorized Official Name and Position | Olukemi Ogunmakinwa (OWNER) |
| Authorized Official Contact | 2403920814 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Toseg Medical Center, Llc 19650 Club House Rd Ste 104 Gaithersburg MD 20886-3039 Ph: () - | Toseg Medical Center, Llc 19650 Club House Rd Ste 104 Gaithersburg MD 20886-3039 Ph: (410) 970-2640 |
| NPI Number | 1942834890 |
|---|---|
| Provider Enumeration Date | 03/01/2020 |
| Last Update Date | 03/01/2020 |
| Medicare PECOS PAC ID | 1759710940 |
|---|---|
| Medicare Enrollment ID | O20200409002310 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942834890 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Olukemi B Ogunmakinwa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629439948 PECOS PAC ID: 9133408453 Enrollment ID: I20161109001372 |
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