| NPI | 1497934426 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWNE M CARROLL Medical Director 301-818-1243 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0042719) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101041759) |
| 207Q00000X Family Medicine (Licence: DC MD16892) | |
| Enumeration Date | 2007-10-26 |
| Last Update Date | 2023-04-13 |