Healthcare Provider Details

I. General information

NPI: 1386507986
Provider Name (Legal Business Name): PLUS WELLBEING MEDICAL GROUP PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4445 WILLARD AVE STE 600
CHEVY CHASE MD
20815-3786
US

IV. Provider business mailing address

4445 WILLARD AVE STE 600
CHEVY CHASE MD
20815-3786
US

V. Phone/Fax

Practice location:
  • Phone: 617-362-0233
  • Fax:
Mailing address:
  • Phone: 617-362-0233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: DR. LISA CZANKO
Title or Position: PRESIDENT
Credential: MD
Phone: 617-362-0233