INTERNAL MEDICINE PRACTICE P.A. NPI 1336231950

NPI Information

INTERNAL MEDICINE PRACTICE, P.A. is a primary care clinic center in Hagerstown, MD. INTERNAL MEDICINE PRACTICE, P.A. NPI is 1336231950. The provider is registered as an organization entity type.

The provider's business location address is:

324 E ANTIETAM ST STE 306
HAGERSTOWN, MD
ZIP 21740-768
Phone: (301) 739-0240
Fax: (301) 797-8546

The provider's authorized official is Koduah Peprah .
The authorized official title is Director and has the following contact phone number (301) 996-7900.

The CLIA number assigned to this NPI record is 21D1102610 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/29/2006 and was last updated on 2/6/2012.

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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