Healthcare Provider Details

I. General information

NPI: 1982893483
Provider Name (Legal Business Name): METROPOLITAN ACCESS CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2007
Last Update Date: 02/17/2023
Certification Date: 02/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4155 BLADENSBURG RD
COLMAR MANOR MD
20722-1928
US

IV. Provider business mailing address

4155 BLADENSBURG RD
COLMAR MANOR MD
20722-1928
US

V. Phone/Fax

Practice location:
  • Phone: 847-388-2058
  • Fax: 866-720-9740
Mailing address:
  • Phone: 847-388-2058
  • Fax: 866-720-9740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: FARIS HAKKI
Title or Position: MEDICAL DIRECTOR/PHYSICIAN
Credential: MD
Phone: 202-877-5007