Organization
GILEAD MEDICAL ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THEODORE C OSUALA MD (MEDICAL DIRECTOR)
(301) 577-9111
Entity
Organization
Contact information
Practice address
9470 ANNAPOLIS RD STE 117, LANHAM, MD 20706-3031
(301) 577-9111
(301) 577-9199
Mailing address
9470 ANNAPOLIS RD STE 117, LANHAM, MD 20706-3031
(301) 577-9111
(301) 577-9199
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NONE
—
MD
Enumeration date
08/03/2022
Last updated
08/03/2022
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