His Faithfulness Family Clinic INC
Nurse Practitioner, Family in Oxon Hill, MD. Organization (NPI-2).
NPI number1164030102
StatusActive
Last updated in NPPESJun 29, 2022
Details
- NPI
- 1164030102
- Entity type
- Organization (NPI-2)
- Legal business name
- His Faithfulness Family Clinic INC
- Organization subpart
- No
- Enumeration date
- Jul 15, 2020
- Certification date
- Jun 29, 2022
- Last updated
- Jun 29, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | – | – | Yes |
| 261Q00000X | Clinic/Center | – | – |
Other names
- His Faithfulness Family Clinic INC (Doing Business As)
Practice location
6188 Oxon Hill Rd Ste 301Oxon Hill, MD 20745-3157
Phone 301-485-8151 · Fax 301-485-8191
Mailing address
6188 Oxon Hill Rd Ste 301Oxon Hill, MD 20745-3157
Phone 301-485-8151 · Fax 301-485-8191
Authorized official
Olivia Mbah
Administrator
3012572314
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