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General NPI Number Information
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NPI Number | 1043783905
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Entity Type | Organization
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Legal Business Name | QUALINOVA CARE INC
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Dates
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Enumeration Date | 01/03/2019
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Last Update Date | 01/03/2019
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Provider Practice Location Address
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Address Line | 1310 SOUTHERN AVE SE
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City | WASHINGTON
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State | DC
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Zip | 20032-4623
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Country | US
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Telephone | 202-574-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 10501 STORCH DR
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City | LANHAM
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State | MD
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Zip | 20706-2185
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Country | US
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Telephone | 616-821-8972
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. ISMAEL YUSSUF
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Credential | MD
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Telephone | 616-821-8972
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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