Healthcare Provider Details

I. General information

NPI: 1841354479
Provider Name (Legal Business Name): CIGNET SPECIALIST CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12164 CENTRAL AVE STE 200
MITCHELLVILLE MD
20721-1907
US

IV. Provider business mailing address

3710 RIVIERA ST STE ID
TEMPLE HILLS MD
20748-1719
US

V. Phone/Fax

Practice location:
  • Phone: 301-218-9223
  • Fax: 301-423-4553
Mailing address:
  • Phone: 301-423-4551
  • Fax: 301-423-4553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. CARYL MATTHEW
Title or Position: DIR OF OPERATIONS
Credential: BS
Phone: 301-423-4551