| Northern Virginia Psychiatric Group Pc | |
|
7620 Carroll Ave Suite 200 Takoma Park MD 20912-6387 | |
| (703) 698-5220 | |
| (703) 573-2351 |
| Full Name | Northern Virginia Psychiatric Group Pc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 7620 Carroll Ave, Takoma Park, Maryland |
| Authorized Official Name and Position | Richard Baither (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7036985220 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northern Virginia Psychiatric Group Pc 8500 Executive Park Ave Suite 200 Fairfax VA 22031-2225 Ph: (703) 698-5220 | Northern Virginia Psychiatric Group Pc 7620 Carroll Ave Suite 200 Takoma Park MD 20912-6387 Ph: (703) 698-5220 |
| NPI Number | 1073653515 |
|---|---|
| Provider Enumeration Date | 02/07/2007 |
| Last Update Date | 11/10/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073653515 | NPI | - | NPPES |
| 1547 | Other | DC | CAREFIRST |
| 403204700 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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