Healthcare Provider Details

I. General information

NPI: 1275417040
Provider Name (Legal Business Name): COMPREHENSIVE PRIMARY CARE AND ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2025
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2554 SOLOMONS ISLAND RD
ANNAPOLIS MD
21401-3710
US

IV. Provider business mailing address

15245 SHADY GROVE RD STE 340
ROCKVILLE MD
20850-7201
US

V. Phone/Fax

Practice location:
  • Phone: 703-878-8800
  • Fax:
Mailing address:
  • Phone: 667-303-1042
  • Fax: 667-303-1042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: IAN C LAMPKIN
Title or Position: CREDENTIALING PE SPECIALIST
Credential:
Phone: 667-303-1042