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Organization

DYNMED PRIMARY CARE AND WELLNESS PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EKOP GRAHAM (OWNER)
(301) 526-1004
Entity
Organization

Contact information

Practice address
6510 KENILWORTH AVE STE 2700, RIVERDALE, MD 20737-1353
(301) 526-1004
Mailing address
6510 KENILWORTH AVE STE 2700, RIVERDALE, MD 20737-1353
(301) 526-1004

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Enumeration date
02/05/2020
Last updated
10/20/2021
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