| Elite Multi Specialty Clinic, LLC | |
|
12501 Prosperity Dr Ste 330 Silver Spring MD 20904-1655 | |
| (301) 604-4033 | |
| (240) 645-4013 |
| Full Name | Elite Multi Specialty Clinic, LLC |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 12501 Prosperity Dr Ste 330, Silver Spring, Maryland |
| Authorized Official Name and Position | Adaora Perpetua Noummy (PRESIDENT/OWNER) |
| Authorized Official Contact | 3016044033 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Multi Specialty Clinic, LLC 12501 Prosperity Dr Ste 330 Silver Spring MD 20904-1655 Ph: (301) 604-4033 | Elite Multi Specialty Clinic, LLC 12501 Prosperity Dr Ste 330 Silver Spring MD 20904-1655 Ph: (301) 604-4033 |
| NPI Number | 1053758235 |
|---|---|
| Provider Enumeration Date | 05/29/2013 |
| Last Update Date | 08/11/2020 |
| Certification Date | 08/11/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053758235 | NPI | - | NPPES |
| 945614700 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (NU) | Primary |
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