| Vivis Family Medicine Llc | |
|
3606 Chancelsors Dr Upper Marlboro MD 20772-8194 | |
| (240) 687-4317 | |
| (218) 264-3428 |
| Full Name | Vivis Family Medicine Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3606 Chancelsors Dr, Upper Marlboro, Maryland |
| Authorized Official Name and Position | Hedwig Manga Williams (PROVIDER) |
| Authorized Official Contact | 2406055215 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vivis Family Medicine Llc 3606 Chancelsors Dr Upper Marlboro MD 20772-8194 Ph: (240) 687-4317 | Vivis Family Medicine Llc 3606 Chancelsors Dr Upper Marlboro MD 20772-8194 Ph: (240) 687-4317 |
| NPI Number | 1174237200 |
|---|---|
| Provider Enumeration Date | 01/12/2023 |
| Last Update Date | 01/12/2023 |
| Medicare PECOS PAC ID | 5092187211 |
|---|---|
| Medicare Enrollment ID | O20230215002459 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174237200 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Hedwig E Manga Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487098521 PECOS PAC ID: 7810311479 Enrollment ID: I20200716000716 |
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