Healthcare Provider Details
I. General information
NPI: 1336383835
Provider Name (Legal Business Name): LANHAM NEURO SCIENCE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/28/2009
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9841 GREENBELT RD STE 206
LANHAM MD
20706-6270
US
IV. Provider business mailing address
9841 GREENBELT RD STE 206
LANHAM MD
20706-6270
US
V. Phone/Fax
- Phone: 301-552-0008
- Fax: 301-552-2066
- Phone: 301-552-0008
- Fax: 301-552-2066
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084S0012X |
| Taxonomy | Sleep Medicine (Psychiatry & Neurology) Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084N0600X |
| Taxonomy | Clinical Neurophysiology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084N0400X |
| Taxonomy | Neurology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SHIMELLIS
ALEMAYEHU
Title or Position: OWNER
Credential: MD
Phone: 301-552-6666