Organization
INTEGRATED MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLIVIA NGUH (OWNER)
(410) 521-8000
Entity
Organization
Contact information
Practice address
7404 EXECUTIVE PL STE 100, LANHAM, MD 20706-6237
(240) 758-1782
Mailing address
7404 EXECUTIVE PL STE 100, LANHAM, MD 20706-6237
(240) 260-3827
(240) 260-3830
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/16/2021
Last updated
01/10/2024
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