| Bowie Primary Care, Inc | |
|
4379 Northview Drive Bowie MD 20716 | |
| (301) 262-2627 | |
| (301) 262-8411 |
| Full Name | Bowie Primary Care, Inc |
|---|---|
| Speciality | Pediatrics |
| Location | 4379 Northview Drive, Bowie, Maryland |
| Authorized Official Name and Position | Mariam M Bahrami (OWNER/PARTNER) |
| Authorized Official Contact | 3012622627 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bowie Primary Care, Inc 4379 Northview Drive Bowie MD 20716 Ph: (301) 262-2627 | Bowie Primary Care, Inc 4379 Northview Drive Bowie MD 20716 Ph: (301) 262-2627 |
| NPI Number | 1205011640 |
|---|---|
| Provider Enumeration Date | 01/03/2008 |
| Last Update Date | 03/14/2017 |
| Medicare PECOS PAC ID | 7113101155 |
|---|---|
| Medicare Enrollment ID | O20110415000184 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205011640 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Secondary |
| 208000000X | Pediatrics | () | Primary |
| Provider Name | Mariam Bahrami |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003912742 PECOS PAC ID: 0143402685 Enrollment ID: I20110304000648 |
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