Healthcare Provider Details
I. General information
NPI: 1205783693
Provider Name (Legal Business Name): ACCESSCARE TELEHEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/13/2026
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
211 GRAIDEN ST
UPPER MARLBORO MD
20774-1817
US
IV. Provider business mailing address
211 GRAIDEN ST
UPPER MARLBORO MD
20774-1817
US
V. Phone/Fax
- Phone: 240-544-8707
- Fax:
- Phone: 240-544-8707
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 302F00000X |
| Taxonomy | Exclusive Provider Organization |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 302R00000X |
| Taxonomy | Health Maintenance Organization |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 305R00000X |
| Taxonomy | Preferred Provider Organization |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 305S00000X |
| Taxonomy | Point of Service |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
OBY
A
ATTA
Title or Position: NP
Credential: CRNP
Phone: 301-801-3365