Healthcare Provider Details

I. General information

NPI: 1558326090
Provider Name (Legal Business Name): T AND T HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 05/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6201 GREENBELT RD SUITE M-7
BERWYN HEIGHTS MD
20740-2354
US

IV. Provider business mailing address

PO BOX 87
GREENBELT MD
20768-0087
US

V. Phone/Fax

Practice location:
  • Phone: 301-441-3722
  • Fax: 301-441-2774
Mailing address:
  • Phone: 301-441-3722
  • Fax: 301-441-2774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD0052015
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD0052015
License Number StateMD

VIII. Authorized Official

Name: ATLENER ARTIS-TROWER
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 301-441-3722