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General NPI Number Information
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NPI Number | 1174702237
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Entity Type | Organization
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Legal Business Name | ADVANCED HEALTHCARE CENTER, LLC
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Dates
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Enumeration Date | 10/25/2007
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Last Update Date | 07/25/2012
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Provider Practice Location Address
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Address Line | 1046 WEST ST
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City | LAUREL
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State | MD
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Zip | 20707-3531
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Country | US
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Telephone | 301-490-8383
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Fax | 301-490-9770
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Provider Business Mailing Address
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Address Line | 1046 WEST ST
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City | LAUREL
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State | MD
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Zip | 20707-3531
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Country | US
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Telephone | 301-490-8383
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Fax | 301-490-9770
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. NAOMI NMI IHEDIOHA
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Credential | M.D.
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Telephone | 301-490-8383
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QB0002X
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Taxonomy Name | Obesity Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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