Provider Demographics
NPI:1790559151
Name:ADORN MEDICAL CARE SERVICES, LLC
Entity Type:Organization
Organization Name:ADORN MEDICAL CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:NINI
Authorized Official - Last Name:VEBANGSI
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:240-486-2783
Mailing Address - Street 1:11801 BISHOPS CONTENT RD
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2570
Mailing Address - Country:US
Mailing Address - Phone:240-413-4881
Mailing Address - Fax:
Practice Address - Street 1:4514 BENNING RD SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-5149
Practice Address - Country:US
Practice Address - Phone:202-800-6500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-07
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty