Provider Demographics
NPI:1700042025
Name:BRIGGS CHANEY WALK IN CLINIC, LLC
Entity Type:Organization
Organization Name:BRIGGS CHANEY WALK IN CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TOSTAM
Authorized Official - Middle Name:
Authorized Official - Last Name:NASSIRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-890-8000
Mailing Address - Street 1:13823 OUTLET DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-4971
Mailing Address - Country:US
Mailing Address - Phone:301-890-8000
Mailing Address - Fax:301-890-1485
Practice Address - Street 1:13823 OUTLET DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-4971
Practice Address - Country:US
Practice Address - Phone:301-890-8000
Practice Address - Fax:301-890-1485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-06
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0061989261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care