| Wills Medical Group Pc | |
|
14310 Old Marlboro Pike Upper Marlboro MD 20772-2840 | |
| (301) 627-1448 | |
| (301) 627-5010 |
| Full Name | Wills Medical Group Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 14310 Old Marlboro Pike, Upper Marlboro, Maryland |
| Authorized Official Name and Position | John H Wills (OWNER) |
| Authorized Official Contact | 3016271448 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wills Medical Group Pc 14310 Old Marlboro Pike Upper Marlboro MD 20772-2840 Ph: (301) 627-1448 | Wills Medical Group Pc 14310 Old Marlboro Pike Upper Marlboro MD 20772-2840 Ph: (301) 627-1448 |
| NPI Number | 1053681460 |
|---|---|
| Provider Enumeration Date | 01/03/2012 |
| Last Update Date | 04/20/2012 |
| Medicare PECOS PAC ID | 2668634429 |
|---|---|
| Medicare Enrollment ID | O20120424000671 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053681460 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | D0050389 (Maryland) | Primary |
| Provider Name | John H Wills |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457462806 PECOS PAC ID: 6002709425 Enrollment ID: I20100107000332 |
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