| Landmark Medical Of Tennessee Pc | |
|
1910 Towne Centre Blvd Ste 250 Annapolis MD 21401-3599 | |
| (657) 400-5180 | |
| Not Available |
| Full Name | Landmark Medical Of Tennessee Pc |
|---|---|
| Speciality | General Practice |
| Location | 1910 Towne Centre Blvd Ste 250, Annapolis, Maryland |
| Authorized Official Name and Position | Michael Huy Le (CHIEF MEDICAL OFFICE) |
| Authorized Official Contact | 6574005180 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Landmark Medical Of Tennessee Pc 7755 Center Ave Ste 630 Huntington Beach CA 92647-9152 Ph: () - | Landmark Medical Of Tennessee Pc 1910 Towne Centre Blvd Ste 250 Annapolis MD 21401-3599 Ph: (657) 400-5180 |
| NPI Number | 1922722172 |
|---|---|
| Provider Enumeration Date | 09/30/2022 |
| Last Update Date | 09/30/2022 |
| Medicare PECOS PAC ID | 8527453851 |
|---|---|
| Medicare Enrollment ID | O20230109002147 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922722172 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Alexa Gale |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1487897195 PECOS PAC ID: 5294975900 Enrollment ID: I20130701000122 |
| Provider Name | Yoseph Fisahaye Teweldebrhan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528508009 PECOS PAC ID: 8820361181 Enrollment ID: I20171122002647 |
| Provider Name | Mispa Atah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871006635 PECOS PAC ID: 5395086938 Enrollment ID: I20210616002536 |
| Provider Name | David Moen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942312301 PECOS PAC ID: 9830149624 Enrollment ID: I20230109002321 |
| Provider Name | Kurwa Nyigu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417925272 PECOS PAC ID: 7416928650 Enrollment ID: I20230410002673 |
| Provider Name | Vivian V Tan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649787011 PECOS PAC ID: 3274885447 Enrollment ID: I20230420000458 |
| Provider Name | Edward Kim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952369548 PECOS PAC ID: 8426009119 Enrollment ID: I20230425001689 |
| Provider Name | Chiedozie Eke |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669636494 PECOS PAC ID: 9133394158 Enrollment ID: I20230425002539 |
| Provider Name | Jennifer Dietrich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821496720 PECOS PAC ID: 5597089185 Enrollment ID: I20230612002096 |
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