Healthcare Provider Details

I. General information

NPI: 1053539122
Provider Name (Legal Business Name): FAMILY HEALTHCARE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 05/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20528 BOLAND FARM RD SUITE 104
GERMANTOWN MD
20876-4021
US

IV. Provider business mailing address

20528 BOLAND FARM RD SUITE 104
GERMANTOWN MD
20876-4021
US

V. Phone/Fax

Practice location:
  • Phone: 301-972-0400
  • Fax: 301-916-1453
Mailing address:
  • Phone: 301-972-0400
  • Fax: 301-916-1453

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD0006258
License Number StateMD

VIII. Authorized Official

Name: MONICA H HOWARD
Title or Position: MANAGING PARTNER
Credential: M.D.
Phone: 301-972-0400