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General NPI Number Information
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NPI Number | 1649419102
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Entity Type | Organization
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Legal Business Name | P. MICHAEL PATTERSON
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Dates
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Enumeration Date | 02/06/2009
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | 115 LA GRANGE AVE SUITE 101
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City | LA PLATA
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State | MD
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Zip | 20646-9592
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Country | US
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Telephone | 301-392-1935
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Fax | 301-392-1936
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Provider Business Mailing Address
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Address Line | 115-A LA GRANGE AVE SUITE 101
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City | LA PLATA
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State | MD
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Zip | 20646-9592
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Country | US
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Telephone | 301-392-1935
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Fax | 301-392-1936
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PAUL MICHAEL PATTERSON
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Credential | DNP/FNP
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Telephone | 301-392-1935
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | R148876
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License Number State | MD
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