Organization
PRIMAL HEALTH FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NNEGADI TATAW CRNP (CEO)
(240) 425-2762
Entity
Organization
Contact information
Practice address
3261 OLD WASHINGTON RD STE 2020, WALDORF, MD 20602-3231
(240) 923-0614
Mailing address
3261 OLD WASHINGTON RD STE 2020, WALDORF, MD 20602-3231
(240) 425-2762
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/10/2019
Last updated
10/31/2023
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