Outreach Md Llc - Clinic/Center in Bowie, Maryland | ProviderWire

Legal Business Name

Outreach Md Llc

NPI Number

1235584384

NPI Type

Organization

Enumeration Date

04/26/2016

Specialties

(Taxonomies)

Name

Code

261Q00000X

Primary Taxonomy

Yes

Contact
Information

Purpose

Mailing

Location

Address

2124 4TH AVE S

4201 NORTHVIEW DR

City

Birmingham

Bowie

State

AL

MD

Postal Code

35233-2204

20716-2604

Country

US

US

Telephone Number

(205) 279-8981

(410) 220-1111

Authorized Official

Name

Dr. Ehsan Abdeshahian

Title or Position

MEDICAL DIRECTOR

Telephone Number

(405) 306-0384

Identifiers

Identifier

0714704

Identifier State

MD

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 08/18/2016

Provider Address

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