Organization
ARK VISIONARY HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SALMA KHAN (AUTHORIZED OFFICIAL)
(866) 282-5040
Entity
Organization
Contact information
Practice address
5900 PRINCESS GARDEN PKWY, LANHAM, MD 20706-2925
(240) 883-2660
Mailing address
6902 STORCH CIR, LANHAM, MD 20706-2177
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123456789
STATE LICENSEE
MD
Enumeration date
01/17/2022
Last updated
01/17/2022
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