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Envisioncare Medical Associates, LLC

Clinic/Center in Upper Marlboro, MD. Organization (NPI-2).

NPI number1578729331
StatusActive
Last updated in NPPESJul 31, 2008

Details

NPI
1578729331
Entity type
Organization (NPI-2)
Legal business name
Envisioncare Medical Associates, LLC
Organization subpart
No
Enumeration date
Jul 31, 2008
Last updated
Jul 31, 2008

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/CenterNP117688MDYes

Practice location

10507 Montana Ter
Upper Marlboro, MD 20774-6034

Phone 301-237-7383 · Fax 301-322-9555

Mailing address

1400 Mercantile Ln
Suite 124
Largo, MD 20774-5341

Phone 301-322-9292 · Fax 301-322-9555

Authorized official

Chinwe N Ndubisi
Medical Practitioner
3012377383

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