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Organization
WELLNESS MEDICIAL CENTER LLC
Active
Organization
WELLNESS MEDICIAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ARUNA S NATHAN M.D. (PARTNER)
(301) 942-7900
Entity
Organization
Contact information
Practice address
10901 CONNECTICUT AVE, SUITE 100, KENSINGTON, MD 20895-1645
(301) 942-7900
(301) 942-9837
Mailing address
10901 CONNECTICUT AVE, KENSINGTON, MD 20895-1645
(301) 942-7900
(301) 942-9837
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
133505
PTAN
MD
01
—
133515ZA1X
PTAN
MD
01
—
133518ZA1X
PTAN
MD
01
—
D0053615
STATE LICENSE
MD
01
—
D0057879
STATE LICENSE
MD
Enumeration date
01/31/2008
Last updated
06/11/2009
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