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Organization
SDM-1 STOP PRIMARY & URGENT CARE
Active
Organization
SDM-1 STOP PRIMARY & URGENT CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAURE BERTILLE NDEUTCHOUA FNP-C, DNP (CEO)
(240) 383-8705
Entity
Organization
Contact information
Practice address
6401 NEW HAMPSHIRE AVE, 100, HYATTSVILLE, MD 20783-3201
(301) 466-3593
(240) 764-5571
Mailing address
6401 NEW HAMPSHIRE AVE, 100, HYATTSVILLE, MD 20783-3201
(301) 466-3593
(240) 764-5571
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
—
DC
261QU0200X
Urgent Care Clinic/Center
Primary
R187557
MD
Other
Enumeration date
01/13/2016
Last updated
02/02/2021
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