MEDICARE: VITAL MEDICAL CENTER 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	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1649123241
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VITAL MEDICAL CENTER LLC

Provider Business Mailing Address
First Line	:	8101 OLD SANDY SPRING RD STE 300
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20707-3596
Country	:	US
Telephone Number	:	240-593-2461
Fax Number	:

Provider Business Practice Location Address
First Line	:	8101 OLD SANDY SPRING RD STE 300
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20707-3596
Country	:	US
Telephone Number	:	240-593-2461
Fax Number	:

Authorized Official
Title or Position	:	PROVIDER
Name	:	COLLETTE ANYIAM
Credential	:
Telephone Number	:	240-593-2461

Provider Enumeration Date	:	02/16/2026
Last Update Date	:	02/20/2026

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