# PRIME MD LLC

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

## Provider details

- **NPI number:** 1558540161
- **Authorized official:** DR. SUZAN KHALIL ABDO MD (OWNER/PHYSICIAN)
- **Authorized official phone:** (443) 535-8500

## Contact information

- **Practice address:** 5005 SIGNAL BELL LN, SUITE 202, CLARKSVILLE, MD 21029-2606
- **Practice address phone:** (443) 535-8500
- **Practice address fax:** (410) 531-1446
- **Mailing address:** 5005 SIGNAL BELL LN, SUITE 202, CLARKSVILLE, MD 21029-2606
- **Mailing address phone:** (443) 535-8500
- **Mailing address fax:** (410) 531-1446

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | D0050878 | MD | Yes |
| 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