Provider Demographics
NPI:1891090635
Name:FAMILIES FIRST WELLNESS CENTER
Entity Type:Organization
Organization Name:FAMILIES FIRST WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SULTANA
Authorized Official - Middle Name:J
Authorized Official - Last Name:AFROOZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:1877-328-3178
Mailing Address - Street 1:10005 OLD COLUMBIA RD
Mailing Address - Street 2:SUITE P170
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-1702
Mailing Address - Country:US
Mailing Address - Phone:877-329-3217
Mailing Address - Fax:240-383-3463
Practice Address - Street 1:10005 OLD COLUMBIA RD
Practice Address - Street 2:SUITE P170
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-1702
Practice Address - Country:US
Practice Address - Phone:877-329-3217
Practice Address - Fax:240-383-3463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-25
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH67624207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty