Mana Dermatology LLC
Dermatology in Greenbelt, MD. Organization (NPI-2).
NPI number1336748508
StatusActive
Last updated in NPPESOct 20, 2020
Details
- NPI
- 1336748508
- Entity type
- Organization (NPI-2)
- Legal business name
- Mana Dermatology LLC
- Organization subpart
- No
- Enumeration date
- Oct 20, 2020
- Certification date
- Oct 20, 2020
- Last updated
- Oct 20, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207N00000X | Dermatology | – | – | Yes |
Practice location
7500 Greenway Center Dr Ste 1220Greenbelt, MD 20770-3502
Phone 301-615-1986
Mailing address
7500 Greenway Center Dr Ste 1220Greenbelt, MD 20770-3502
Phone 301-615-1986
Authorized official
Mana Ogholikhan
Owner
3016151986
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