Healthcare Provider Details

I. General information

NPI: 1245967033
Provider Name (Legal Business Name): ICARENOW LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2022
Last Update Date: 02/17/2026
Certification Date: 02/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 WATKINS PARK DR
UPPER MARLBORO MD
20774-1628
US

IV. Provider business mailing address

20 WATKINS PARK DR
UPPER MARLBORO MD
20774-1628
US

V. Phone/Fax

Practice location:
  • Phone: 301-350-8501
  • Fax: 301-350-8503
Mailing address:
  • Phone: 301-350-8500
  • Fax: 301-350-8503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: EJAZ M KHAN
Title or Position: OWNER
Credential: MD
Phone: 540-303-0314