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General NPI Number Information
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NPI Number | 1215651690
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Entity Type | Organization
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Legal Business Name | POTOMAC PSYCHIATRIC WELLNESS PA
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Dates
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Enumeration Date | 09/29/2022
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Last Update Date | 09/29/2022
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Provider Practice Location Address
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Address Line | 1201 SEVEN LOCKS RD STE 360
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City | POTOMAC
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State | MD
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Zip | 20854-6901
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Country | US
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Telephone | 240-599-0811
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Fax | 240-238-8580
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Provider Business Mailing Address
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Address Line | 11436 BEECHGROVE LN
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City | POTOMAC
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State | MD
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Zip | 20854-1801
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Country | US
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Telephone | 301-580-2252
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Fax | 240-238-8580
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Authorized Official
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Title or Position | OWNER
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Name | MARTA JEAN HOPKINSON
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Credential | MD
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Telephone | 240-599-0811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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