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General NPI Number Information
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NPI Number | 1336948728
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Entity Type | Organization
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Legal Business Name | PREMIER WELLNESS HEALTHCARE
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Dates
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Enumeration Date | 03/10/2025
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 103 N MAIN ST
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City | BEL AIR
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State | MD
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Zip | 21014-3539
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Country | US
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Telephone | 888-333-1345
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Fax | 410-732-2025
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Provider Business Mailing Address
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Address Line | 103 N MAIN ST
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City | BEL AIR
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State | MD
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Zip | 21014-3539
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Country | US
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Telephone | 888-333-1345
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Fax | 410-732-2025
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Authorized Official
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Title or Position | OWNER
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Name | CYNTHIA DICARA
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Credential |
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Telephone | 888-653-3933
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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