MEDICARE: PRIVIUM CONSULTANTS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	208D00000X	General Practice Physician
3	207LP2900X	Pain Medicine (Anesthesiology) Physician	H0077516	MD

General Provider Information

NPI Number	:	1386171510
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIVIUM CONSULTANTS LLC

Provider Business Mailing Address
First Line	:	8222 SCHULTZ RD STE 100A
Second Line	:
City	:	CLINTON
State	:	MD
Zip	:	20735-2607
Country	:	US
Telephone Number	:	301-317-0020
Fax Number	:	301-317-0028

Provider Business Practice Location Address
First Line	:	8222 SCHULTZ RD STE 100A
Second Line	:
City	:	CLINTON
State	:	MD
Zip	:	20735-2607
Country	:	US
Telephone Number	:	202-221-8442
Fax Number	:	202-221-8443

Authorized Official
Title or Position	:	OWNER
Name	:	ADAKU U NWACHUKU
Credential	:	DO
Telephone Number	:	301-595-8802

Provider Enumeration Date	:	05/18/2017
Last Update Date	:	11/05/2025

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Directions to “PRIVIUM CONSULTANTS LLC ” Practice Location

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