Organization
MARYLAND PRIMARY CARE AND WELLNESS
Active
Parent organization
MARYLAND PRIMARY CARE AND WELLNESS
Organization subpart
Yes
Provider details
NPI number
Legal business name
MARYLAND PRIMARY CARE AND WELLNESS
Authorized official
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
Mailing address
7100 LONGWOOD DR, BETHESDA, MD 20817-2120
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
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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