| NPI | 1154571321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANOHAR KUMAR CHENCHUGALLA President 301-445-1452 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: MD D67876) |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care (Licence: VA 0101242881) |
| Enumeration Date | 2008-09-24 |
| Last Update Date | 2011-02-09 |