Organization
CHARISS FAMILY MEDICAL CLINIC AND MED SPA INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTIANA CHINYERE KEKE-EKEKWE NP (OWNER)
(240) 770-4315
Entity
Organization
Contact information
Practice address
9470 ANNAPOLIS ROAD SUITE 401, LANHAM, MD 20706
(240) 770-4315
(240) 770-4417
Mailing address
9470 ANNAPOLIS RD STE 401, LANHAM, MD 20706-3025
(240) 770-4315
(240) 770-4417
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
R124903
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
448130500
—
MD
Enumeration date
02/11/2014
Last updated
05/23/2014
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