| Phs Family Medicine Glenn Dale | |
|
12200 Annapolis Rd Suite 118 Glenn Dale MD 20769-9182 | |
| (301) 464-9300 | |
| (202) 854-4093 |
| Full Name | Phs Family Medicine Glenn Dale |
|---|---|
| Speciality | Family Medicine |
| Location | 12200 Annapolis Rd, Glenn Dale, Maryland |
| Authorized Official Name and Position | Charles F Haberkern (VP) |
| Authorized Official Contact | 2028544255 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phs Family Medicine Glenn Dale 1160 Varnum St Ne St Catherine's Hall, Room 102 Washington DC 20017-2107 Ph: (202) 854-4069 | Phs Family Medicine Glenn Dale 12200 Annapolis Rd Suite 118 Glenn Dale MD 20769-9182 Ph: (301) 464-9300 |
| NPI Number | 1962842401 |
|---|---|
| Provider Enumeration Date | 06/28/2013 |
| Last Update Date | 09/06/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962842401 | NPI | - | NPPES |
| 029833400 | Medicaid | DC | |
| 09810714 | Medicaid | VA | |
| 005145400 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | HFD01-0212 (District Of Columbia) | Primary |
| 282N00000X | General Acute Care Hospital | HFD01-0212 (District Of Columbia) | Secondary |
Privia Medical Group, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12150 Annapolis Rd Ste 300, Glenn Dale, MD 20769 Phone: 301-249-5384 | |
Maryland Specialty Group Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12200 Annapolis Rd, Suite# 123, Glenn Dale, MD 20769 Phone: 301-552-9495 Fax: 301-552-9743 | |
Privia Medical Group, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12150 Annapolis Rd Ste 212, Glenn Dale, MD 20769 Phone: 301-337-2004 | |
Proactive Healthcare Services Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7023 Corner Creek Way, Glenn Dale, MD 20769 Phone: 227-218-8737 | |
Prime Medicine Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 12150 Annapolis Rd, Suite 308, Glenn Dale, MD 20769 Phone: 301-805-0006 Fax: 301-805-5757 | |
Morayo Medical Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 12200 Annapolis Rd Ste 324, Glenn Dale, MD 20769 Phone: 301-291-7077 Fax: 301-291-7073 | |
Zenith Medical Care, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5808 Marietta Station Dr, Glenn Dale, MD 20769 Phone: 240-654-2389 Fax: 240-205-8617 |