| Custom Made Weight Loss And Nursing Solutions | |
|
372 Main St Ste 2 Laurel MD 20707-4133 | |
| (240) 294-4079 | |
| Not Available |
| Full Name | Custom Made Weight Loss And Nursing Solutions |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 372 Main St Ste 2, Laurel, Maryland |
| Authorized Official Name and Position | Bermesola M Dyer (CEO) |
| Authorized Official Contact | 2025055207 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Custom Made Weight Loss And Nursing Solutions 372 Main St Ste 2 Laurel MD 20707-4133 Ph: (240) 294-4079 | Custom Made Weight Loss And Nursing Solutions 372 Main St Ste 2 Laurel MD 20707-4133 Ph: (240) 294-4079 |
| NPI Number | 1093361057 |
|---|---|
| Provider Enumeration Date | 08/15/2019 |
| Last Update Date | 07/22/2025 |
| Medicare PECOS PAC ID | 2860812781 |
|---|---|
| Medicare Enrollment ID | O20201027003090 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093361057 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QB0002X | Family Medicine - Obesity Medicine | (* (Not Available)) | Secondary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Primary |
| Provider Name | Bermesola M Dyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205170206 PECOS PAC ID: 8729231436 Enrollment ID: I20130109000077 |
| Provider Name | Danushca Pardo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326433061 PECOS PAC ID: 9537430822 Enrollment ID: I20170804000890 |
| Provider Name | Ashlei J Parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801494695 PECOS PAC ID: 9638584758 Enrollment ID: I20210223000050 |
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