| NPI | 1144454141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORA M MAMODESENE President 202-489-1277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: DC 14222MD) |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care (Licence: MD D0029649MD) |
| 261QP2300X Clinic/Center Primary Care (Licence: VA 0101035678) | |
| Enumeration Date | 2009-05-06 |
| Last Update Date | 2009-05-06 |