| Patrick White LLC | |
|
19301 Watkins Mill Rd Montgomery Village MD 20886-6914 | |
| (410) 745-9509 | |
| Not Available |
| Full Name | Patrick White LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 19301 Watkins Mill Rd, Montgomery Village, Maryland |
| Authorized Official Name and Position | Patrick W White (OWNER) |
| Authorized Official Contact | 4107469509 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Patrick White LLC 2850 Pebble Beach Dr Ellicott City MD 21042-7604 | Patrick White LLC 19301 Watkins Mill Rd Montgomery Village MD 20886-6914 Ph: (410) 745-9509 |
| NPI Number | 1508623034 |
|---|---|
| Provider Enumeration Date | 03/01/2024 |
| Last Update Date | 03/01/2024 |
| Certification Date | 03/01/2024 |
| Medicare PECOS PAC ID | 6305376948 |
|---|---|
| Medicare Enrollment ID | O20250211003392 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508623034 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (NU) | Primary |
| Provider Name | Patrick W. White |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508929571 PECOS PAC ID: 3476719378 Enrollment ID: I20150929000340 |
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