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Contact Information

SUNRISE MEDICAL CLINIC, LLC
6201 GREENBELT RD
SUITE M-17
COLLEGE PARK, MD20740-2354
 Phone: 301-220-9500
 Fax: 301-982-0321
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for SUNRISE MEDICAL CLINIC, LLC

NPI Number 1871824391
LBN Legal business name SUNRISE MEDICAL CLINIC, LLC
Authorized official MAGDALENE OJIEGBE - (MANAGER)
Entity Organization
Organization subpart 1 Yes
Enumeration date 01/22/2010
Last updated 03/07/2023 - About 3 years ago
Identifiers
MD License # D0065418
MD Medicaid 027374100
MD Other 11328638 CAQH
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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