Patricia Abernathy-Clark, PA-C
Individual provider Active NPI Medical Physician Assistant · Lanham, MD
NPI 1154615938 · NPPES record last updated Jun 8, 2011
Key facts
- NPI
- 1154615938
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- C0003282 (MD)
- Practice address
- 7404 Executive PL
502
Lanham, MD 20706-2268 - Phone
- (301) 249-2700
- Fax
- (301) 249-4559
- NPI assigned
- Jun 8, 2011
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C0003282 | MD | MD | Medical Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | C0003282 | MD | Yes |
Addresses
Primary practice location
7404 Executive PL
502
Lanham, MD 20706-2268
Mailing address
7404 Executive PL
502
Lanham, MD 20706-2268
Phone (301) 249-2700
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All providers in Lanham, MD · Medical Physician Assistant in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 8, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.