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REVIVE MEDICAL & AESTHETIC CLINIC NPI 1104536358


NPI Information

NPI: 1104536358
Provider Name: REVIVE MEDICAL & AESTHETIC CLINIC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
7313 HANOVER PKWY STE A
GREENBELT, MD
ZIP 20770
Phone: (301) 412-5522
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REVIVE MEDICAL & AESTHETIC CLINIC is a primary care clinic center in Greenbelt, MD. REVIVE MEDICAL & AESTHETIC CLINIC NPI is 1104536358. The provider is registered as an organization entity type.

The provider's business location address is:

7313 HANOVER PKWY STE A
GREENBELT, MD
ZIP 20770-667
Phone: (301) 412-5522
Fax: (301) 498-7436

The provider's authorized official is Florence Ukenye .
The authorized official title is Clinical Director and has the following contact phone number (301) 412-5522.

The enumeration date for this NPI number is 11/29/2022 and was last updated on 11/29/2022.


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
1261QP2300XClinic/CenterPrimary CareYes

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
1NAOTHERNA

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.