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General NPI Number Information
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NPI Number | 1831549757
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Entity Type | Organization
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Legal Business Name | GILEAD MEDICAL ASSOCIATES
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Dates
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Enumeration Date | 06/22/2016
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Last Update Date | 04/16/2024
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Provider Practice Location Address
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Address Line | 1818 NEW YORK AVE NE STE 213
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City | WASHINGTON
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State | DC
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Zip | 20002-1849
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Country | US
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Telephone | 301-577-9111
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Fax | 301-577-9199
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Provider Business Mailing Address
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Address Line | 9470 ANNAPOLIS RD SUITE 117
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City | LANHAM
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State | MD
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Zip | 20706-3025
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Country | US
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Telephone | 301-577-9111
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Fax | 301-577-9199
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THEODORE CHINATU OSUALA
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Credential | MD
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Telephone | 301-237-0897
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | DOO64126
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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