# BRANCH MEDICAL CLINIC INDIAN HEAD

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** NAVAL HEALTH CLINIC PATUXENT RIVER
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1841498417
- **Legal business name:** NAVAL HEALTH CLINIC PATUXENT RIVER
- **Authorized official:** MR. WILLIAM MICHAEL CONDON (NAVY MEDICINE UBO PROGRAM MANAGER)
- **Authorized official phone:** (240) 401-3643

## Contact information

- **Practice address:** 4141 W WILSON RD, SUITE105, INDIAN HEAD, MD 20640-5162
- **Practice address phone:** (301) 744-4601
- **Mailing address:** 4141 W WILSON RD, SUITE105, INDIAN HEAD, MD 20640-5162

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1100X | Military/U.S. Coast Guard Outpatient Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 07/05/2007
- **Last updated:** 12/19/2017