Krystal Medical Associates

LBN: Krystal Medical Associates Llc
Krystal Medical Associates is an health care organization with primary practice located at 12150 Annapolis Rd Suite 100, Glenn Dale MD 20769-9183. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Multi-Specialty, Ambulatory Health Care Facilities / Primary Care. Ambulatory Health Care Facilities / Primary Care is the primary health care specialty. Krystal Medical Associates Llc can be contacted via phone (301) 464-7601, or through Onyeaghala, Nwaehihie H via phone (301) 486-0100.

Contact Information

Primary practice address
12150 Annapolis Rd Suite 100 Glenn Dale MD 20769-9183
Fax: (866) 885-9817
Website:
Authorized official contact:
Name: Onyeaghala, Nwaehihie H Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Multi-Specialty 261QM1300X D0053461 Maryland
Ambulatory Health Care Facilities / Primary Care 261QP2300X D0053461 Maryland

Profile Details

NPI number 1164604187
LBN Legal business name Krystal Medical Associates Llc
DBA Doing business as Krystal Medical Associates
Authorized official Onyeaghala, Nwaehihie H Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 30th, 2007
Last updated Aug 18th, 2014 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164604187 NPPES
Maryland MEDICAID 402647100
Maryland MEDICAID 010012902
Maryland MEDICAID 034934800

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