Healthcare Provider Details

I. General information

NPI: 1710327382
Provider Name (Legal Business Name): SACRED HEART MEDICAL GROUP P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2013
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7525 GREENWAY CENTER DR STE 204
GREENBELT MD
20770-3525
US

IV. Provider business mailing address

7525 GREENWAY CENTER DR STE 204
GREENBELT MD
20770-3525
US

V. Phone/Fax

Practice location:
  • Phone: 240-542-4810
  • Fax:
Mailing address:
  • Phone: 240-542-4810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD0068121
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberD0068121
License Number StateMD

VIII. Authorized Official

Name: DR. GABRIEL OBOITE
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 240-542-4810