Organization
MARYLAND PRIMARY CARE AND WELLNESS
Active
Parent organization
MARYLAND PRIMARY CARE AND WELLNESS,LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MARYLAND PRIMARY CARE AND WELLNESS,LLC
Authorized official
DR. ALBERT ENOW ENOW TAKEM MD (OWNER)
(240) 408-6286
Entity
Organization
Contact information
Practice address
14314 OLD MARLBORO PIKE, UPPER MARLBORO, MD 20772-2840
(301) 627-3500
(301) 627-1634
Mailing address
7100 LONGWOOD DR, BETHESDA, MD 20817-2120
(240) 408-6286
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
924025000
—
MD
Enumeration date
12/01/2020
Last updated
12/01/2020
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