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Contact Information

MY MED CLINIC PA
19731 EXECUTIVE PARK CIR
GERMANTOWN, MD20874-2642
 Phone: 301-698-3245
 Fax: 301-698-3246
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for MY MED CLINIC PA · (Female)

NPI # 1245403849
Status Active
Credentials
Entity Individual
Enumeration date 04/04/2008
Last updated 12/25/2013 - About 12 years ago
Sole proprietor 1 Not specified
Identifiers
  • MD License # D0065301
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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