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General NPI Number Information
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NPI Number | 1639573348
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Entity Type | Organization
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Legal Business Name | AFFORDABLE MEDICAL CLINIC LLC
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Dates
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Enumeration Date | 10/09/2014
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Last Update Date | 08/11/2020
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Provider Practice Location Address
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Address Line | 6475 NEW HAMPSHIRE AVE SUITE 430
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City | HYATTSVILLE
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State | MD
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Zip | 20783-3269
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Country | US
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Telephone | 240-670-8305
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Fax | 240-670-8306
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Provider Business Mailing Address
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Address Line | 6475 NEW HAMPSHIRE AVENUE SUITE 430
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City | HYATTSVILLE
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State | MD
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Zip | 20783
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Country | US
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Telephone | 240-670-8305
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Fax | 240-670-8306
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Authorized Official
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Title or Position | CEO
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Name | JOSEPHINE EMEAGWALI
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Credential | NP
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Telephone | 301-412-7990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R134072
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License Number State | MD
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