Provider First Line Business Practice Location Address:
8901 WISCONSIN AVE
Provider Second Line Business Practice Location Address:
INTERNAL MEDICINE CLINIC, BLDG 19
Provider Business Practice Location Address City Name:
BETHESDA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20814
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-295-0196
Provider Business Practice Location Address Fax Number:
301-400-0618
Provider Enumeration Date:
01/04/2017