| Ethelaura Care Clinics LLC | |
|
12530 Fairwood Pkwy Ste 102-307 Bowie MD 20720-6356 | |
| (301) 728-7200 | |
| Not Available |
| Full Name | Ethelaura Care Clinics LLC |
|---|---|
| Speciality | Clinic/center |
| Location | 12530 Fairwood Pkwy Ste 102-307, Bowie, Maryland |
| Authorized Official Name and Position | Eronmwon Yvonne Okonjo (CEO) |
| Authorized Official Contact | 3017287200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ethelaura Care Clinics LLC 12530 Fairwood Pkwy Ste 102-307 Bowie MD 20720-6356 Ph: (301) 728-7200 | Ethelaura Care Clinics LLC 12530 Fairwood Pkwy Ste 102-307 Bowie MD 20720-6356 Ph: (301) 728-7200 |
| NPI Number | 1154218543 |
|---|---|
| Provider Enumeration Date | 06/19/2025 |
| Last Update Date | 06/19/2025 |
| Certification Date | 06/18/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154218543 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (NU) | Primary |
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