Healthcare Provider Details
I. General information
NPI: 1093039570
Provider Name (Legal Business Name): MAJOR MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/26/2010
Last Update Date: 09/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1300 SPRING ST SUITE 122
SILVER SPRING MD
20910-3616
US
IV. Provider business mailing address
2129 CLARK PL
SILVER SPRING MD
20910-1175
US
V. Phone/Fax
- Phone: 301-585-1833
- Fax: 240-235-3898
- Phone: 301-585-1833
- Fax: 240-235-3898
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | MD036021 |
| License Number State | DC |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | MD64592 |
| License Number State | MD |
VIII. Authorized Official
Name: DR.
MARK
AMMAAN
MAJOR
Title or Position: DOCTOR/OWNER
Credential: M.D.
Phone: 301-585-1833