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General NPI Number Information
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NPI Number | 1063603777
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Entity Type | Organization
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Legal Business Name | TOTAL HEALTH MEDICAL CENTER, PC
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Dates
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Enumeration Date | 08/07/2007
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Last Update Date | 01/31/2012
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Provider Practice Location Address
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Address Line | 12106 OLD LINE CTR
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City | WALDORF
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State | MD
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Zip | 20602-2553
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Country | US
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Telephone | 301-645-8898
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Fax | 240-222-3280
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Provider Business Mailing Address
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Address Line | 34 SHINING WILLOW WAY # 288
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City | LA PLATA
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State | MD
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Zip | 20646-4224
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Country | US
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Telephone | 301-645-8898
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Fax | 240-222-3280
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDWIN L LIPSITZ
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Credential | D.C.
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Telephone | 301-645-8898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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