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Organization

COMMUNITY CLINIC, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SONYA BRUTON (CEO)
(866) 520-9102
Entity
Organization

Contact information

Practice address
220 GIRARD ST # 100, GAITHERSBURG, MD 20877-3467
(301) 216-0880
(301) 216-2891
Mailing address
8665 GEORGIA AVE, SILVER SPRING, MD 20910-3405
(301) 340-7525
(301) 495-0318

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
133V00000X
Registered Dietitian
207R00000X
Internal Medicine Physician
208000000X
Pediatrics Physician
2080A0000X
Pediatric Adolescent Medicine Physician
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
363LF0000X
Family Nurse Practitioner
363LW0102X
Women's Health Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
130061000
MD
Enumeration date
02/13/2007
Last updated
11/09/2023
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