MONTGOMERY COUNTY MARYLAND GOVERNMENT NPI 1033478292

NPI Information

NPI: 1033478292
Provider Name: MONTGOMERY COUNTY MARYLAND GOVERNMENT
Classification: Clinic/Center - 261QP2300X
Specialization: Primary Care
Entity Type: Organization
:
CLIA Number: 21D2043389
Address: 705 BAYFIELD ST
TAKOMA PARK, MD
ZIP 20912
Phone: (301) 431-7603

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NPI Details

MONTGOMERY COUNTY MARYLAND GOVERNMENT is a primary care clinic center in Takoma Park, MD. MONTGOMERY COUNTY MARYLAND GOVERNMENT NPI is 1033478292. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

705 BAYFIELD ST
TAKOMA PARK, MD
ZIP 20912-307
Phone: (301) 431-7603

The provider's authorized official is Diana Azucena Cortez .
The authorized official title is Management and has the following contact phone number (240) 672-6758.

The CLIA number assigned to this NPI record is 21D2043389 - school/student health service with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/9/2012 and was last updated on 9/9/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	625403900	MEDICAID	MARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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