Organization
PROHEALTH PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NATHANIEL SUMILANG M.D. (PHYSICIAN/OWNER)
(410) 272-3377
Entity
Organization
Contact information
Practice address
115 W BEL AIR AVE, ABERDEEN, MD 21001-3221
(410) 272-3377
(410) 273-1479
Mailing address
115 W BEL AIR AVE, ABERDEEN, MD 21001-3221
(410) 272-3377
(410) 273-1479
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
M38486
MD
208000000X
Pediatrics Physician
Primary
D0059126
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
402019701
—
MD
Enumeration date
05/01/2012
Last updated
05/01/2012
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