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Organization

79TH MEDICAL GROUP MALCOLM GROW MEDICAL CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. NATALIE YVETTE GISCOMBE REGISTERED NURSE (ADULT NURSE PRACTITIONER)
(240) 857-4951
Entity
Organization

Contact information

Practice address
1050 W PERIMETER RD, MALCOLM GROW MEDICAL CENTER, ANDREWS AIR FORCE BASE, MD 20762-6601
(240) 857-4951
(240) 857-7138
Mailing address
11423 PLENTY GATES CT, WALDORF, MD 20601-5601
(301) 645-3357
(240) 857-7138

Taxonomy

Speciality
Code
Description
License number
State
286500000X
Military Hospital
Primary
RN64518
DC

Other

Enumeration date
02/07/2007
Last updated
06/13/2008
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