Provider Demographics
NPI:1932857182
Name:FIDELITY HEALTH AND WELLNESS CENTER, LLC
Entity Type:Organization
Organization Name:FIDELITY HEALTH AND WELLNESS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FIDELIS
Authorized Official - Middle Name:
Authorized Official - Last Name:DOH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:240-264-6846
Mailing Address - Street 1:2 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-1866
Mailing Address - Country:US
Mailing Address - Phone:240-264-6846
Mailing Address - Fax:
Practice Address - Street 1:2 N 2ND ST
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-1866
Practice Address - Country:US
Practice Address - Phone:240-264-6846
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-16
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care