| Vital Mind | |
|
525 Eastern Ave Ste B3 Fairmount Heights MD 20743-1677 | |
| (703) 980-0478 | |
| Not Available |
| Full Name | Vital Mind |
|---|---|
| Speciality | Clinic/Center |
| Location | 525 Eastern Ave Ste B3, Fairmount Heights, Maryland |
| Authorized Official Name and Position | Ebunoluwa Lawal (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 7039800478 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vital Mind 525 Eastern Ave Ste B3 Fairmount Heights MD 20743-1677 Ph: () - | Vital Mind 525 Eastern Ave Ste B3 Fairmount Heights MD 20743-1677 Ph: (703) 980-0478 |
| NPI Number | 1205553955 |
|---|---|
| Provider Enumeration Date | 10/24/2022 |
| Last Update Date | 02/09/2024 |
| Certification Date | 02/09/2024 |
| Medicare PECOS PAC ID | 5496192189 |
|---|---|
| Medicare Enrollment ID | O20240802003059 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205553955 | NPI | - | NPPES |
| Provider Name | Gayduo Barr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992410278 PECOS PAC ID: 2668819350 Enrollment ID: I20240802003370 |
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