| Waverly Internal Medicine, Llc | |
|
11165 Stratfield Ct First Floor Marriottsville MD 21104-1650 | |
| (410) 442-8065 | |
| (410) 442-8067 |
| Full Name | Waverly Internal Medicine, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 11165 Stratfield Ct, Marriottsville, Maryland |
| Authorized Official Name and Position | Ndidi Bonique Feinberg (PHYSICIAN/OWNER) |
| Authorized Official Contact | 2406016434 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Waverly Internal Medicine, Llc 11165 Stratfield Ct 1st Floor Marriottsville MD 21104-1625 Ph: (410) 442-8065 | Waverly Internal Medicine, Llc 11165 Stratfield Ct First Floor Marriottsville MD 21104-1650 Ph: (410) 442-8065 |
| NPI Number | 1194966648 |
|---|---|
| Provider Enumeration Date | 03/13/2009 |
| Last Update Date | 06/07/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194966648 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Charter Internal Medicine, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2470 Longstone Ln Ste I, Marriottsville, MD 21104 Phone: 410-910-2300 Fax: 410-740-9134 |