| Mind Health Pc | |
|
1647 Benning Rd Ne Ste 304 Washington DC 20002-4588 | |
| (301) 233-5054 | |
| (301) 218-1908 |
| Full Name | Mind Health Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1647 Benning Rd Ne Ste 304, Washington, District Of Columbia |
| Authorized Official Name and Position | Ismail M Kalokoh (CEO/PHYSICIAN) |
| Authorized Official Contact | 3012335054 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mind Health Pc 1709 Kings Manor Dr Bowie MD 20721-2001 Ph: (301) 233-5054 | Mind Health Pc 1647 Benning Rd Ne Ste 304 Washington DC 20002-4588 Ph: (301) 233-5054 |
| NPI Number | 1639946635 |
|---|---|
| Provider Enumeration Date | 12/08/2023 |
| Last Update Date | 03/18/2024 |
| Certification Date | 03/18/2024 |
| Medicare PECOS PAC ID | 0345789491 |
|---|---|
| Medicare Enrollment ID | O20240903003202 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639946635 | NPI | - | NPPES |
| Provider Name | Ismail Kalokoh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912959073 PECOS PAC ID: 3779626809 Enrollment ID: I20100211000278 |
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