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NPI Code Detail

MEDICARE: INDIA ALEXANDRIA CONWELL

MEDICARE: INDIA ALEXANDRIA CONWELL
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
1106S00000XBehavior TechnicianMD

General Provider Information

NPI Number : 1710831102
Entity Type Code : Individual
Provider Name (Legal Business Name) : INDIA ALEXANDRIA CONWELL
Provider Business Mailing Address
First Line : 12424 PERSIMMON RD
Second Line :
City : UPPER MARLBORO
State : MD
Zip : 20772-5137
Country : US
Telephone Number : 202-867-3140
Fax Number :
Provider Business Practice Location Address
First Line : 4741 COLONEL ASHTON PL
Second Line :
City : UPPER MARLBORO
State : MD
Zip : 20772-2881
Country : US
Telephone Number : 301-379-9654
Fax Number : 240-377-0226
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2026
Last Update Date : 02/24/2026

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Directions to “ INDIA ALEXANDRIA CONWELL ” Practice Location

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