Healthcare Provider Details
I. General information
NPI: 1750555785
Provider Name (Legal Business Name): WOMEN KIDS & TEENS AFTERHOURS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/22/2008
Last Update Date: 01/17/2022
Certification Date: 01/17/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9801 GEORGIA AVE STE 224
SILVER SPRING MD
20902-5276
US
IV. Provider business mailing address
7500 HANOVER PKWY SUITE 202
GREENBELT MD
20770-2010
US
V. Phone/Fax
- Phone: 301-592-0050
- Fax: 301-592-8005
- Phone: 301-489-1400
- Fax: 301-489-1405
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: DR.
JULIET
I
ANADU
Title or Position: MANAGER
Credential: MD
Phone: 301-489-1400