MEDICARE: DR. PHILLIP H OMOHUNDRO M.D.

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	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	MD13399	DC
2	207X00000X	Orthopaedic Surgery Physician	D25458	MD
3	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	D0025458	MD
4	207X00000X	Orthopaedic Surgery Physician	MD13399	DC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871553594
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHILLIP H OMOHUNDRO M.D.

Provider Business Mailing Address
First Line	:	12200 ANNAPOLIS RD STE 123
Second Line	:
City	:	GLENN DALE
State	:	MD
Zip	:	20769-9182
Country	:	US
Telephone Number	:	301-364-9292
Fax Number	:	855-291-3304

Provider Business Practice Location Address
First Line	:	12200 ANNAPOLIS RD STE 123
Second Line	:
City	:	GLENN DALE
State	:	MD
Zip	:	20769-9182
Country	:	US
Telephone Number	:	301-364-9292
Fax Number	:	855-291-3304

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2006
Last Update Date	:	01/08/2024

Similar Medicare Providers

1710985452 — CRAIG MICHAEL THOMAS M.D.
Practice Location Address:

12200 ANNAPOLIS RD STE 123
GLENN DALE, MD
20769-9182

Practice Phone: 301-364-9292
Practice Fax: 855-291-3304

1083686794 — MR. BARRY EUGENE THOMPSON PA-C
Practice Location Address:

12200 ANNAPOLIS RD STE 123
GLENN DALE, MD
20769-9182

Practice Phone: 301-364-9292
Practice Fax: 301-552-9743

1265472567 — IKECHI F OKWARA MD
Practice Location Address:

12200 ANNAPOLIS RD , STE 316
GLENN DALE, MD
20769-9182

Practice Phone: 301-313-0600
Practice Fax:

1306881271 — DR. CLIFFORD MICHAEL GALANIS M.D.
Practice Location Address:

12200 ANNAPOLIS RD STE 320
GLENN DALE, MD
20769-9182

Practice Phone: 301-218-3700
Practice Fax: 301-218-3909

1972512408 — KWASI A DEBRA MD
Practice Location Address:

12200 ANNAPOLIS RD , STE 123
GLENN DALE, MD
20769-9182

Practice Phone: 301-552-9495
Practice Fax: 301-552-9743

1588732424 — RENEE C BOVELLE M.D.
Practice Location Address:

12200 ANNAPOLIS RD , SUITE 116
GLENN DALE, MD
20769-9182

Practice Phone: 301-805-4664
Practice Fax: 301-805-4663

Directions to “ DR. PHILLIP H OMOHUNDRO M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.