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Organization
PRIME MD LLC
Active
Organization
PRIME MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUZAN KHALIL ABDO MD (OWNER/PHYSICIAN)
(443) 535-8500
Entity
Organization
Contact information
Practice address
5005 SIGNAL BELL LN, SUITE 202, CLARKSVILLE, MD 21029-2606
(443) 535-8500
(410) 531-1446
Mailing address
5005 SIGNAL BELL LN, SUITE 202, CLARKSVILLE, MD 21029-2606
(443) 535-8500
(410) 531-1446
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0050878
MD
320800000X
Mental Illness Community Based Residential Treatment Facility
D046855
MD
320800000X
Mental Illness Community Based Residential Treatment Facility
D50870
MD
Other
Enumeration date
10/31/2007
Last updated
09/16/2010
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