MEDICARE: POTOMAC SLEEP AND WELLNESS

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	261QS1200X	Sleep Disorder Diagnostic Clinic/Center

General Provider Information

NPI Number	:	1427258052
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POTOMAC SLEEP AND WELLNESS

Provider Business Mailing Address
First Line	:	350 FORTUNE TER
Second Line	:
City	:	ROCKVILLE
State	:	MD
Zip	:	20854-2981
Country	:	US
Telephone Number	:	443-839-6966
Fax Number	:

Provider Business Practice Location Address
First Line	:	350 FORTUNE TER
Second Line	:
City	:	ROCKVILLE
State	:	MD
Zip	:	20854-2981
Country	:	US
Telephone Number	:	443-839-6966
Fax Number	:

Authorized Official
Title or Position	:	SENIOR SLEEP TECHNOLOGIST
Name	:	MR. ALVIN C BAIRD JR.
Credential	:
Telephone Number	:	443-839-6966

Provider Enumeration Date	:	07/22/2007
Last Update Date	:	07/23/2007

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Directions to “POTOMAC SLEEP AND WELLNESS ” Practice Location

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