# BETHEL MEDICAL CLINIC CHARTERED

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

## Provider details

- **NPI number:** 1174625057
- **Authorized official:** BABAJIDE AYODEJI OBADINA M.D., (MEDICAL DIRECTOR)
- **Authorized official phone:** (301) 345-3966

## Contact information

- **Practice address:** 7325 HANOVER PKWY, SUITE A, GREENBELT, MD 20770-3618
- **Practice address phone:** (301) 345-3966
- **Practice address fax:** (301) 982-2937
- **Mailing address:** 7325 HANOVER PKWY, SUITE A, GREENBELT, MD 20770-3618
- **Mailing address phone:** (301) 345-3966
- **Mailing address fax:** (301) 982-2937

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 207RH0003X | Hematology & Oncology Physician | — | NULL | — |
| 207RH0003X | Hematology & Oncology Physician | — | — | — |

## Other

- **Enumeration date:** 09/02/2006
- **Last updated:** 08/08/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 127041900 | — | MD |
| 01 | — | C500 | CAREFIRSTBCBS DC GROUP \# | DC |
| 01 | — | KP71BE | CAREFIRST BCBS GROUP \# | MD |