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General NPI Number Information
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NPI Number | 1235609330
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Entity Type | Organization
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Legal Business Name | METRO MEN'S HEALTH MARYLAND, LLC
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Dates
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Enumeration Date | 11/30/2018
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Last Update Date | 11/30/2018
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Provider Practice Location Address
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Address Line | 11300 ROCKVILLE PIKE STE 406
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City | ROCKVILLE
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State | MD
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Zip | 20852-3083
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Country | US
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Telephone | 301-710-6510
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Fax |
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Provider Business Mailing Address
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Address Line | 11300 ROCKVILLE PIKE STE 406
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City | ROCKVILLE
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State | MD
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Zip | 20852-3083
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Country | US
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Telephone | 301-710-6510
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Fax |
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Authorized Official
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Title or Position | PATIENT CARE MANAGER
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Name | MR. SAMMIE SHORTER JR.
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Credential |
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Telephone | 301-710-6510
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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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