Organization Name: | TOTAL HEALTH MEDICAL CENTER, PC |
NPI Number: | 1063603777 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | EDWIN L LIPSITZ (PRESIDENT) |
Mailing Address: | 12106 Old Line Ctr Waldorf |
State: | MD US |
Postal Code: | 206022553 |
Phone Number: | 3016458898 |
Fax Number: | 2402223280 |
NPI Enumeration Date: | 08/07/2007 |
NPI Last Update Date: | 01/31/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM1300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Multi-Specialty |
Taxonomy Definition: |