| Omni Primary & Urgent Care | |
|
20 Watkins Park Dr Upper Marlboro MD 20774-1628 | |
| (301) 350-8501 | |
| (301) 350-8503 |
| Full Name | Omni Primary & Urgent Care |
|---|---|
| Speciality | Family Medicine |
| Location | 20 Watkins Park Dr, Upper Marlboro, Maryland |
| Authorized Official Name and Position | Ejaz M Khan (OWNER) |
| Authorized Official Contact | 5403030314 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Omni Primary & Urgent Care 20 Watkins Park Dr Upper Marlboro MD 20774-1628 Ph: (301) 350-8500 | Omni Primary & Urgent Care 20 Watkins Park Dr Upper Marlboro MD 20774-1628 Ph: (301) 350-8501 |
| NPI Number | 1245967033 |
|---|---|
| Provider Enumeration Date | 08/02/2022 |
| Last Update Date | 02/17/2026 |
| Certification Date | 02/17/2026 |
| Medicare PECOS PAC ID | 1355717042 |
|---|---|
| Medicare Enrollment ID | O20221020002904 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245967033 | NPI | - | NPPES |
| Provider Name | Philip Laurence Mussenden |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598108318 PECOS PAC ID: 7315237229 Enrollment ID: I20161219002528 |
| Provider Name | Ejaz Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669416160 PECOS PAC ID: 7810991908 Enrollment ID: I20221020002997 |
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