MEDICARE: PRIMARY MEDICINE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1164374245
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIMARY MEDICINE LLC

Provider Business Mailing Address
First Line	:	PO BOX 2510
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20709-2510
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1302 CRONSON BLVD STE E
Second Line	:
City	:	CROFTON
State	:	MD
Zip	:	21114-2064
Country	:	US
Telephone Number	:	410-451-1301
Fax Number	:

Authorized Official
Title or Position	:	MD
Name	:	KAVEH SADEGHI
Credential	:
Telephone Number	:	301-498-9494

Provider Enumeration Date	:	02/11/2026
Last Update Date	:	02/11/2026

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Directions to “PRIMARY MEDICINE LLC ” Practice Location

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