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Organization

ADDIS ALEM MEDICINE, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARYANN MILLER (OFFICE MANAGER)
(240) 494-6882
Entity
Organization

Contact information

Practice address
7300 VAN DUSEN RD, LAUREL, MD 20707-9463
(240) 494-6882
(202) 403-0508
Mailing address
16501 SHADY GROVE RD, 7275, GAITHERSBURG, MD 20898-9201
(240) 494-6882
(202) 403-0508

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
D0069430
MD
207RI0200X
Infectious Disease Physician

Other

Enumeration date
10/12/2011
Last updated
03/04/2014
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