Organization
MID ATLANTIC MEDICAL MANAGEMENT , LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ATLEE T WAMPLER IV DC (CEO/OWNER)
(678) 524-6828
Entity
Organization
Contact information
Practice address
3050 CRAIN HWY STE 101A, WALDORF, MD 20601-2823
(240) 754-7130
Mailing address
PO BOX 566455, ATLANTA, GA 31156-6455
(770) 504-5162
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
D0068492
MD
Other
Enumeration date
11/04/2016
Last updated
11/04/2016
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