Provider Demographics
NPI:1053633768
Name:LANHAM INTERNAL MEDICINE ASSOCIATES, LLC
Entity Type:Organization
Organization Name:LANHAM INTERNAL MEDICINE ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REXFORD
Authorized Official - Middle Name:
Authorized Official - Last Name:BABILAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-459-1691
Mailing Address - Street 1:9470 ANNAPOLIS RD
Mailing Address - Street 2:SUITE 306
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3025
Mailing Address - Country:US
Mailing Address - Phone:301-459-1691
Mailing Address - Fax:301-577-2473
Practice Address - Street 1:9470 ANNAPOLIS RD
Practice Address - Street 2:SUITE 306
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3025
Practice Address - Country:US
Practice Address - Phone:301-459-1691
Practice Address - Fax:301-577-2473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-22
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD66658207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty