Organization
PRIME MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FARHAD JAMALI M.D. (OWNER)
(301) 805-0006
Entity
Organization
Contact information
Practice address
12150 ANNAPOLIS RD, SUITE 308, GLENN DALE, MD 20769-9183
(301) 805-0006
(301) 805-5757
Mailing address
PO BOX 569, GREENBELT, MD 20768-0569
(301) 805-0006
(301) 805-5757
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0058213
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
415340500
—
MD
Enumeration date
07/25/2007
Last updated
12/09/2011
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