Provider Demographics
NPI:1831985043
Name:AVEC MOI MEDICAL CENTER LLC
Entity type:Organization
Organization Name:AVEC MOI MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JANNATUL SHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOQUE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:240-540-5585
Mailing Address - Street 1:3720 FARRAGUT AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-2110
Mailing Address - Country:US
Mailing Address - Phone:240-540-5585
Mailing Address - Fax:
Practice Address - Street 1:3720 FARRAGUT AVE STE 103
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-2110
Practice Address - Country:US
Practice Address - Phone:240-540-5585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center