Organization
BRANCH MEDICAL CLINIC INDIAN HEAD
Active
Parent organization
NAVAL HEALTH CLINIC PATUXENT RIVER
Organization subpart
Yes
Provider details
NPI number
Legal business name
NAVAL HEALTH CLINIC PATUXENT RIVER
Authorized official
MR. WILLIAM MICHAEL CONDON (NAVY MEDICINE UBO PROGRAM MANAGER)
(240) 401-3643
Entity
Organization
Contact information
Practice address
4141 W WILSON RD, SUITE105, INDIAN HEAD, MD 20640-5162
(301) 744-4601
Mailing address
4141 W WILSON RD, SUITE105, INDIAN HEAD, MD 20640-5162
Taxonomy
Speciality
Code
Description
License number
State
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
Primary
—
—
Other
Enumeration date
07/05/2007
Last updated
12/19/2017
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