| Fairwood Internal Medicine | |
|
12200 Annapolis Rd Suite 232 Glenn Dale MD 20769-9180 | |
| (240) 245-4414 | |
| (240) 245-4409 |
| Full Name | Fairwood Internal Medicine |
|---|---|
| Speciality | Internal Medicine |
| Location | 12200 Annapolis Rd, Glenn Dale, Maryland |
| Authorized Official Name and Position | Okeowo Darcy Ibitoye (MEDICAL DIRECTOR) |
| Authorized Official Contact | 2402454414 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairwood Internal Medicine 12200 Annapolis Rd Suite 232 Glenn Dale MD 20769-9180 Ph: (240) 245-4414 | Fairwood Internal Medicine 12200 Annapolis Rd Suite 232 Glenn Dale MD 20769-9180 Ph: (240) 245-4414 |
| NPI Number | 1396986873 |
|---|---|
| Provider Enumeration Date | 03/13/2009 |
| Last Update Date | 07/21/2009 |
| Medicare PECOS PAC ID | 6002973187 |
|---|---|
| Medicare Enrollment ID | O20090317000027 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396986873 | NPI | - | NPPES |
| 723540200 | Medicaid | MD | |
| P366 | Other | MD | CAREFIRST FEP |
| DX1GOD | Other | MD | CAREFIRST MARYLAND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | D0051437 (Maryland) | Primary |
| Provider Name | Okeowo D Ibitoye |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154322352 PECOS PAC ID: 7012074198 Enrollment ID: I20090317000022 |
Privia Medical Group, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12150 Annapolis Rd Ste 300, Glenn Dale, MD 20769 Phone: 301-249-5384 | |
Maryland Specialty Group Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12200 Annapolis Rd, Suite# 123, Glenn Dale, MD 20769 Phone: 301-552-9495 Fax: 301-552-9743 | |
Prime Medicine Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 12150 Annapolis Rd, Suite 308, Glenn Dale, MD 20769 Phone: 301-805-0006 Fax: 301-805-5757 | |
Zenith Medical Care, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5808 Marietta Station Dr, Glenn Dale, MD 20769 Phone: 240-654-2389 Fax: 240-205-8617 | |
Krystal Medical Associates Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 12150 Annapolis Rd, Suite 100, Glenn Dale, MD 20769 Phone: 301-464-7601 Fax: 866-885-9817 | |
Inclusive Health Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 12200 Annapolis Rd Ste 316, Glenn Dale, MD 20769 Phone: 301-313-0600 Fax: 301-313-0603 | |
Maryland Family Healthcare, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12150 Annapolis Rd, Suite 212, Glenn Dale, MD 20769 Phone: 301-860-0002 Fax: 301-860-0504 |