| Centreville Family Medicine | |
|
202 Coursevall Dr Centreville MD 21617-2804 | |
| (410) 758-3303 | |
| (410) 758-3310 |
| Full Name | Centreville Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 202 Coursevall Dr, Centreville, Maryland |
| Authorized Official Name and Position | Peter Odenwald (VP BUSINESS DEVELOPMENT) |
| Authorized Official Contact | 4434816415 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Centreville Family Medicine Po Box 12622 Belfast ME 04915-4017 Ph: (443) 481-6572 | Centreville Family Medicine 202 Coursevall Dr Centreville MD 21617-2804 Ph: (410) 758-3303 |
| NPI Number | 1952564528 |
|---|---|
| Provider Enumeration Date | 07/03/2008 |
| Last Update Date | 05/24/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952564528 | NPI | - | NPPES |
| 407175117 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | D35048 (Maryland) | Primary |
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