Healthcare Provider Details

I. General information

NPI: 1669371019
Provider Name (Legal Business Name): PRIMEMED LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2026
Last Update Date: 11/03/2026
Certification Date: 11/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 HYDE RD
SILVER SPRING MD
20902-3047
US

IV. Provider business mailing address

6815 MAURLEEN RD
BALTIMORE MD
21209-1422
US

V. Phone/Fax

Practice location:
  • Phone: 301-244-8557
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ELIYAHU WIENER
Title or Position: OWNER
Credential:
Phone: 410-499-3799