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General NPI Number Information
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NPI Number | 1073334801
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE PRIMARY CARE AND ASSOCIATES, LLC
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Dates
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Enumeration Date | 10/23/2024
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Last Update Date | 04/01/2025
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Provider Practice Location Address
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Address Line | 20410 OBSERVATION DR STE 210
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City | GERMANTOWN
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State | MD
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Zip | 20876-6422
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Country | US
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Telephone | 301-407-1466
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Fax | 301-417-4941
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Provider Business Mailing Address
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Address Line | 15245 SHADY GROVE RD STE 340
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City | ROCKVILLE
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State | MD
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Zip | 20850-7201
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Country | US
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Telephone | 301-869-9776
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Fax | 301-417-4947
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Authorized Official
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Title or Position | CREDENTIALING PE SPECIALIST
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Name | IAN C LAMPKIN
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Credential |
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Telephone | 667-303-1042
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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