Healthcare Provider Details

I. General information

NPI: 1417700717
Provider Name (Legal Business Name): WASHINGTON MEDICAL CLINIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2024
Last Update Date: 04/08/2024
Certification Date: 04/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10230 NEW HAMPSHIRE AVE STE 340
SILVER SPRING MD
20903-1400
US

IV. Provider business mailing address

12515 OLD GUNPOWDER RD
BELTSVILLE MD
20705-1151
US

V. Phone/Fax

Practice location:
  • Phone: 301-750-8000
  • Fax: 301-326-4545
Mailing address:
  • Phone: 301-908-2116
  • Fax: 301-326-4545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH NWAKEGO OBI
Title or Position: OWNER
Credential: NP
Phone: 301-908-2116