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General NPI Number Information
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NPI Number | 1164374245
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Entity Type | Organization
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Legal Business Name | PRIMARY MEDICINE LLC
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Dates
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Enumeration Date | 02/11/2026
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Last Update Date | 02/11/2026
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Provider Practice Location Address
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Address Line | 1302 CRONSON BLVD STE E
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City | CROFTON
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State | MD
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Zip | 21114-2064
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Country | US
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Telephone | 410-451-1301
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2510
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City | LAUREL
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State | MD
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Zip | 20709-2510
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MD
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Name | KAVEH SADEGHI
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Credential |
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Telephone | 301-498-9494
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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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