| Benew a Professional LLC | |
|
9500 Medical Center Dr Ste 105 Largo MD 20774-3703 | |
| (301) 615-4133 | |
| Not Available |
| Full Name | Benew a Professional LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 9500 Medical Center Dr Ste 105, Largo, Maryland |
| Authorized Official Name and Position | Uloma Ibe (MANAGING MEMBER) |
| Authorized Official Contact | 2027043010 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Benew a Professional LLC 9500 Medical Center Dr Ste 105 Largo MD 20774-3703 Ph: (301) 615-4133 | Benew a Professional LLC 9500 Medical Center Dr Ste 105 Largo MD 20774-3703 Ph: (301) 615-4133 |
| NPI Number | 1629789573 |
|---|---|
| Provider Enumeration Date | 12/12/2022 |
| Last Update Date | 12/12/2022 |
| Certification Date | 12/12/2022 |
| Medicare PECOS PAC ID | 2466955489 |
|---|---|
| Medicare Enrollment ID | O20250915000254 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629789573 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Uloma C Ibe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649667940 PECOS PAC ID: 9931494614 Enrollment ID: I20250915000284 |
| Provider Name | Paul Newman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013361054 PECOS PAC ID: 3870886807 Enrollment ID: I20260116003797 |
| Provider Name | Nicole Marie Weidinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467642173 PECOS PAC ID: 4385897800 Enrollment ID: I20260116003851 |
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