Provider Demographics
NPI:1649550930
Name:ADVANCED WALK IN URGENT CARE LLC
Entity type:Organization
Organization Name:ADVANCED WALK IN URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NAOMI
Authorized Official - Middle Name:
Authorized Official - Last Name:IHEDIOHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-860-0888
Mailing Address - Street 1:10801 LOCKWOOD DR
Mailing Address - Street 2:SUITE 140
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-1556
Mailing Address - Country:US
Mailing Address - Phone:301-860-0888
Mailing Address - Fax:301-860-0889
Practice Address - Street 1:10801 LOCKWOOD DR
Practice Address - Street 2:SUITE 140
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-1556
Practice Address - Country:US
Practice Address - Phone:301-860-0888
Practice Address - Fax:301-860-0889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-18
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0047838207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty