Healthcare Provider Details

I. General information

NPI: 1366651598
Provider Name (Legal Business Name): DARMON MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 11/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 MERCANTILE LN STE 180
LARGO MD
20774-5369
US

IV. Provider business mailing address

1400 MERCANTILE LANE #180
LARGO MD
20774
US

V. Phone/Fax

Practice location:
  • Phone: 301-925-7022
  • Fax: 301-925-7022
Mailing address:
  • Phone: 301-925-7022
  • Fax: 301-925-7022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number105387
License Number StateMD

VIII. Authorized Official

Name: MONISOLA AUGUSTA ADEYEMO
Title or Position: NP
Credential: NP
Phone: 301-925-7022