| Washington Medical Clinic, Llc | |
|
12510 Prosperity Dr Suite # 320 Silver Spring MD 20904-1663 | |
| (301) 755-3380 | |
| (866) 596-1084 |
| Full Name | Washington Medical Clinic, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 12510 Prosperity Dr, Silver Spring, Maryland |
| Authorized Official Name and Position | Elizabeth N. Obi (PRESIDENT /OWNER) |
| Authorized Official Contact | 3019082116 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Washington Medical Clinic, Llc 12515 Old Gunpowder Rd Beltsville MD 20705-1151 Ph: (301) 908-2116 | Washington Medical Clinic, Llc 12510 Prosperity Dr Suite # 320 Silver Spring MD 20904-1663 Ph: (301) 755-3380 |
| NPI Number | 1427444108 |
|---|---|
| Provider Enumeration Date | 04/09/2015 |
| Last Update Date | 04/09/2015 |
| Medicare PECOS PAC ID | 3870803737 |
|---|---|
| Medicare Enrollment ID | O20151104001563 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427444108 | NPI | - | NPPES |
| F1213055 | Other | MD | AMERICAN ACADEMY NURSE PRACTITONERS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | R142632 (Maryland) | Primary |
| Provider Name | Elizabeth N Obi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891110623 PECOS PAC ID: 3870818180 Enrollment ID: I20150209001141 |
| Provider Name | Mirabel Alumba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356732259 PECOS PAC ID: 0345633210 Enrollment ID: I20220217001462 |
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