Organization
PREVENTMD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RITA DELORES WUTOH M.D. (OWNER)
(410) 804-7200
Entity
Organization
Contact information
Practice address
7800 CENTRAL AVE, HYATTSVILLE, MD 20785-4807
(410) 804-7200
(301) 218-7916
Mailing address
7800 CENTRAL AVE, HYATTSVILLE, MD 20785-4807
(410) 804-7200
(301) 218-7916
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
12/28/2020
Last updated
12/28/2020
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