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General NPI Number Information
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NPI Number | 1760560031
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Entity Type | Organization
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Legal Business Name | COMPLETE FAMILY CARE PC
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7610 CARROLL AVE # 260
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City | TAKOMA PARK
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State | MD
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Zip | 20912
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Country | US
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Telephone | 301-891-9770
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Fax | 301-891-1620
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Provider Business Mailing Address
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Address Line | PO BOX 7398
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City | LANGLEY PARK
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State | MD
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Zip | 20787
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Country | US
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Telephone | 301-891-9770
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Fax | 301-891-1620
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. SURESH K KHETAN
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Credential | MD
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Telephone | 301-891-9770
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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 | D55403
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License Number State | MD
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