ET FAMILY PRACTICE INC. NPI 1124364757

NPI Information

ET FAMILY PRACTICE, INC. is a family nurse practitioner in Greenbelt, MD. ET FAMILY PRACTICE, INC. NPI is 1124364757. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

7231 HANOVER PKWY STE A
GREENBELT, MD
ZIP 20770-027
Phone: (240) 386-9682
Fax: (301) 477-7352

The provider's authorized official is Eta Stephen Tataw .
The authorized official title is Owner and has the following contact phone number (301) 982-7898.

The CLIA number assigned to this NPI record is 21D0883563 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/1/2013 and was last updated on 2/24/2023.

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:

Other Identifiers

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

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