| Weightloss & Sleep Disorder Center Of Maryland Llc | |
|
1110 Opal Ct Ste 4&5 Hagerstown MD 21740-5942 | |
| (301) 745-6392 | |
| Not Available |
| Full Name | Weightloss & Sleep Disorder Center Of Maryland Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1110 Opal Ct Ste 4&5, Hagerstown, Maryland |
| Authorized Official Name and Position | Mohammad Jawad Miran (MEMBER) |
| Authorized Official Contact | 5168104496 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Weightloss & Sleep Disorder Center Of Maryland Llc 2105 Twin Peaks Ct Frederick MD 21702-5916 Ph: () - | Weightloss & Sleep Disorder Center Of Maryland Llc 1110 Opal Ct Ste 4&5 Hagerstown MD 21740-5942 Ph: (301) 745-6392 |
| NPI Number | 1245743202 |
|---|---|
| Provider Enumeration Date | 11/13/2017 |
| Last Update Date | 05/07/2018 |
| Medicare PECOS PAC ID | 1557620077 |
|---|---|
| Medicare Enrollment ID | O20180109000287 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245743202 | NPI | - | NPPES |
| 0098990 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | H0083539 (Maryland) | Primary |
| 261QS1200X | Clinic/center - Sleep Disorder Diagnostic | H0083539 (Maryland) | Secondary |
| Provider Name | Mohammad Jawad Miran |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700824125 PECOS PAC ID: 2466461538 Enrollment ID: I20180124000591 |
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