Provider Demographics
NPI:1336451194
Name:WELLNESS-PLUS MEDICAL CENTER LLC
Entity Type:Organization
Organization Name:WELLNESS-PLUS MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:
Authorized Official - First Name:SIMA
Authorized Official - Middle Name:NOURANI
Authorized Official - Last Name:ZENUZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-547-7797
Mailing Address - Street 1:10008 EDWARD AVE
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-2114
Mailing Address - Country:US
Mailing Address - Phone:202-413-1720
Mailing Address - Fax:
Practice Address - Street 1:650 PENNSYLVANIA AVE SE
Practice Address - Street 2:#340
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003
Practice Address - Country:US
Practice Address - Phone:202-547-7797
Practice Address - Fax:202-547-6494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-09
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD33821207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty