| Heal Thyself LLC | |
|
4000 Mitchellville Rd Ste A308 Bowie MD 20716-3135 | |
| (017) 588-9293 | |
| Not Available |
| Full Name | Heal Thyself LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 4000 Mitchellville Rd Ste A308, Bowie, Maryland |
| Authorized Official Name and Position | Anna B. Mccall (PHYSICIAN) |
| Authorized Official Contact | 3018502069 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heal Thyself LLC 4000 Mitchellville Rd Ste A308 Bowie MD 20716-3135 Ph: (301) 850-2069 | Heal Thyself LLC 4000 Mitchellville Rd Ste A308 Bowie MD 20716-3135 Ph: (017) 588-9293 |
| NPI Number | 1306576434 |
|---|---|
| Provider Enumeration Date | 06/13/2022 |
| Last Update Date | 03/29/2024 |
| Certification Date | 03/29/2024 |
| Medicare PECOS PAC ID | 8325412638 |
|---|---|
| Medicare Enrollment ID | O20230327002848 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306576434 | NPI | - | NPPES |
| 355028100 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Primary |
| Provider Name | Anna Balkisue Lee Stuart Mccall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306092135 PECOS PAC ID: 8820144876 Enrollment ID: I20090916000821 |
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