Organization
GRACE MEDICAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOSSIEN TALEBIAN (BILLING MGR)
(703) 955-4923
Entity
Organization
Contact information
Practice address
5550 FRIENDSHIP BLVD STE 360, CHEVY CHASE, MD 20815-7256
(240) 235-5202
(240) 341-1290
Mailing address
5550 FRIENDSHIP BLVD STE 360, CHEVY CHASE, MD 20815-7256
(240) 235-5202
(240) 341-1290
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D71554
PHYSICIAN LICENSE
MD
01
—
M91155
CDS REGISTRATION
MD
Enumeration date
01/29/2020
Last updated
03/07/2023
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