| Evidence Physical Therapy, Llc | |
|
12150 Annapolis Rd Ste 201, Glenn Dale, MD 20769 | |
| (301) 352-8370 | |
| (301) 352-8372 |
| Full Name | Evidence Physical Therapy, Llc |
|---|---|
| Type | Facility |
| Speciality | Clinic/center - Physical Therapy |
| Location | 12150 Annapolis Rd Ste 201, Glenn Dale, Maryland |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831493030 | NPI | - | NPPES |
| 616235300 | Other | WORKERS COMPENSATION NUMBER | |
| 045308100 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2251X0800X | Physical Therapist - Orthopedic | 21846 (Maryland) | Secondary |
| 261QP2000X | Clinic/center - Physical Therapy | (* (Not Available)) | Primary |
| Provider Name | Meghan S Mahar |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1033264528 PECOS PAC ID: 5092737361 Enrollment ID: I20051229000787 |
| Provider Name | Emmanuel O Moses |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1588742514 PECOS PAC ID: 9931385135 Enrollment ID: I20110524000797 |
| Provider Name | Karen G Peralta |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1770710881 PECOS PAC ID: 1557591104 Enrollment ID: I20140228000078 |
| Provider Name | Joann U Teh |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1336556281 PECOS PAC ID: 4284854662 Enrollment ID: I20141007001205 |
| Provider Name | Rashada Thompson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1770951923 PECOS PAC ID: 6103134051 Enrollment ID: I20150928000069 |
| Provider Name | Avan M Raimalwala |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1831590561 PECOS PAC ID: 8426374687 Enrollment ID: I20161104000858 |
| Provider Name | Lisa Jordan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1194069237 PECOS PAC ID: 6103061122 Enrollment ID: I20170404001131 |
| Provider Name | Shital Patel |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1962044503 PECOS PAC ID: 2264865054 Enrollment ID: I20191210000139 |
| Provider Name | Patricia Marie Orrence Reynolds |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1710504212 PECOS PAC ID: 3476977737 Enrollment ID: I20200720001346 |
| Provider Name | Enoh Okodiko |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1699388835 PECOS PAC ID: 8729408935 Enrollment ID: I20201008002215 |
| Provider Name | Adeola Oke |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1831826544 PECOS PAC ID: 0244613495 Enrollment ID: I20220819002913 |
| Provider Name | Fnu Sindhuja Gunasekaran |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1235762923 PECOS PAC ID: 5092146118 Enrollment ID: I20230301002871 |
| Provider Name | Haripriya Chirala Naga |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1235706375 PECOS PAC ID: 5193190437 Enrollment ID: I20230418002910 |
| Provider Name | Jalpa Kotadia |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1356114920 PECOS PAC ID: 3274983200 Enrollment ID: I20240103000730 |
| Provider Name | Rafaela Martin Barbosa |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1912485194 PECOS PAC ID: 9739531336 Enrollment ID: I20241003000479 |
| Provider Name | Man Mohita |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1639867393 PECOS PAC ID: 2668905233 Enrollment ID: I20241104003858 |
| Provider Name | Chinonso Blessing Modozie |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1114735149 PECOS PAC ID: 9537699673 Enrollment ID: I20250205001206 |
| Provider Name | Hetvi Sanjaykumar Shah |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1083411698 PECOS PAC ID: 9234650227 Enrollment ID: I20250306001807 |
| Mailing Address | Practice Location Address |
|---|---|
| Evidence Physical Therapy, Llc 12150 Annapolis Rd, Suite 201, Glenn Dale, MD 20769-9183 Ph: (301) 352-8370 | Evidence Physical Therapy, Llc 12150 Annapolis Rd Ste 201, Glenn Dale, MD 20769 Ph: (301) 352-8370 |