Healthcare Provider Details

I. General information

NPI: 1083528004
Provider Name (Legal Business Name): ACCESS WELLNESS MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6535 CLUBHOUSE DR
LAUREL MD
20708-3400
US

IV. Provider business mailing address

6535 CLUBHOUSE DR
LAUREL MD
20708-3400
US

V. Phone/Fax

Practice location:
  • Phone: 240-486-6049
  • Fax:
Mailing address:
  • Phone: 240-486-6049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: AMAKA NWADIUGWU
Title or Position: OWNER
Credential: CNRP
Phone: 240-486-6049