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General NPI Number Information
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NPI Number | 1932760899
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Entity Type | Organization
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Legal Business Name | ELITE FAMILY CARE AND CLINIC
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Dates
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Enumeration Date | 06/21/2019
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Last Update Date | 01/11/2024
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Provider Practice Location Address
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Address Line | 14301 LAYHILL RD STE 101
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City | SILVER SPRING
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State | MD
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Zip | 20906-1937
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Country | US
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Telephone | 301-323-8520
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Fax |
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Provider Business Mailing Address
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Address Line | 14301 LAYHILL RD STE 101
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City | SILVER SPRING
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State | MD
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Zip | 20906-1937
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Country | US
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Telephone | 301-323-8520
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Fax |
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER
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Name | HENRY TAMA
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Credential | NP
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Telephone | 703-868-2839
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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 |
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License Number State |
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