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General NPI Number Information
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NPI Number | 1447429634
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Entity Type | Organization
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Legal Business Name | CAPITAL PRIMARY CARE INC
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Dates
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Enumeration Date | 02/21/2008
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Last Update Date | 04/06/2010
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Provider Practice Location Address
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Address Line | 17 FIRSTFIELD RD SUITE 200
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City | GAITHERSBURG
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State | MD
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Zip | 20878-1774
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Country | US
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Telephone | 301-977-9077
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Fax |
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Provider Business Mailing Address
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Address Line | 17 FIRSTFIELD RD SUITE 200
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City | GAITHERSBURG
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State | MD
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Zip | 20878-1774
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Country | US
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Telephone | 301-977-9077
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | CHRISTIAN NNAMDI NWANKWO
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Credential | M.D
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Telephone | 301-977-9077
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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 | D0044239
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License Number State | MD
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