| Morayo Medical LLC | |
|
12200 Annapolis Rd Ste 324 Glenn Dale MD 20769-9184 | |
| (301) 291-7077 | |
| (301) 291-7073 |
| Full Name | Morayo Medical LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 12200 Annapolis Rd Ste 324, Glenn Dale, Maryland |
| Authorized Official Name and Position | Patricia Oshodi (CEO) |
| Authorized Official Contact | 2026742576 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Morayo Medical LLC 2702 Swann Wing Ct Glenarden MD 20706-1683 Ph: (202) 674-2576 | Morayo Medical LLC 12200 Annapolis Rd Ste 324 Glenn Dale MD 20769-9184 Ph: (301) 291-7077 |
| NPI Number | 1154039162 |
|---|---|
| Provider Enumeration Date | 11/08/2022 |
| Last Update Date | 05/21/2024 |
| Certification Date | 05/21/2024 |
| Medicare PECOS PAC ID | 1456716737 |
|---|---|
| Medicare Enrollment ID | O20230421000595 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154039162 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (NU) | Primary |
| 207Q00000X | Family Medicine | (NU) | Secondary |
| Provider Name | Patricia Oshodi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558516187 PECOS PAC ID: 9133250624 Enrollment ID: I20110616000521 |
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