Organization
BALI HEALTHCARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALFRED SIBEDWO (PRESIDENT/CEO)
(301) 364-3300
Entity
Organization
Contact information
Practice address
1841 BRIGHTSEAT RD, LANDOVER, MD 20785-4250
(301) 364-3300
(301) 364-3305
Mailing address
PO BOX 6854, LARGO, MD 20792-6854
(301) 364-3300
(301) 364-3305
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0052015
MD
2084P0800X
Psychiatry Physician
D0052015
MD
Other
Enumeration date
11/15/2013
Last updated
11/19/2013
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