Healthcare Provider Details
I. General information
NPI: 1902559461
Provider Name (Legal Business Name): OMG HOLDING LLC DBA ARCPOINT LABS SOUTHERN MARYLAND
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/03/2022
Last Update Date: 02/03/2022
Certification Date: 02/03/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6 POST OFFICE RD STE 102
WALDORF MD
20602-2746
US
IV. Provider business mailing address
6 POST OFFICE RD STE 102
WALDORF MD
20602-2746
US
V. Phone/Fax
- Phone: 301-645-5227
- Fax: 301-645-5227
- Phone: 301-645-5227
- Fax: 301-645-5227
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
STEVEN
POWELL
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 603-828-3759