# MAFOT & ASSOCIATES MEDICAL SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104248541
- **Authorized official:** DAGOBERT SIMO MD (DIRECTOR)
- **Authorized official phone:** (240) 432-1924

## Contact information

- **Practice address:** 1403 MADISON PARK DR STE 200, GLEN BURNIE, MD 21061-6427
- **Practice address phone:** (410) 487-6902
- **Practice address fax:** (410) 487-6982
- **Mailing address:** 11183 COLUMBIA PIKE, SILVER SPRING, MD 20901-4507

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | D0073466 | MD | Yes |

## Other

- **Enumeration date:** 01/18/2014
- **Last updated:** 08/31/2022