| Lifetouch Family Clinic Llc | |
|
9801 Greenbelt Rd Ste 103 Lanham MD 20706-6204 | |
| (202) 257-2130 | |
| Not Available |
| Full Name | Lifetouch Family Clinic Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 9801 Greenbelt Rd Ste 103, Lanham, Maryland |
| Authorized Official Name and Position | Esabella Tebid Mbah (NP) |
| Authorized Official Contact | 2022572130 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifetouch Family Clinic Llc 9801 Greenbelt Rd Ste 104 Lanham MD 20706-6204 Ph: () - | Lifetouch Family Clinic Llc 9801 Greenbelt Rd Ste 103 Lanham MD 20706-6204 Ph: (202) 257-2130 |
| NPI Number | 1023729076 |
|---|---|
| Provider Enumeration Date | 12/12/2022 |
| Last Update Date | 03/14/2024 |
| Medicare PECOS PAC ID | 8820461031 |
|---|---|
| Medicare Enrollment ID | O20230308001472 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023729076 | NPI | - | NPPES |
| R174293 | Medicaid | MD |
| Provider Name | Esabella Mah Tebid Mbah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730511981 PECOS PAC ID: 0547544926 Enrollment ID: I20170302001733 |
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