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General NPI Number Information
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NPI Number | 1053448381
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Entity Type | Organization
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Legal Business Name | COMPLETE CARE MEDICAL CENTER INC
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4522 BEECH RD
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City | TEMPLE HILLS
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State | MD
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Zip | 20748-6704
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Country | US
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Telephone | 301-316-2009
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Fax | 301-316-2015
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Provider Business Mailing Address
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Address Line | 4522 BEECH RD
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City | TEMPLE HILLS
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State | MD
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Zip | 20748-6704
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Country | US
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Telephone | 301-316-2009
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Fax | 301-316-2015
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Authorized Official
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Title or Position | VICE PRES
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Name | ANNA M THOMPSON
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Credential |
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Telephone | 301-316-2009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 661788
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License Number State | MD
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