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

LicenseStateTypeSpecialty
C0003282MDMDMedical Physician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

Other providers in Lanham, MD

All providers in Lanham, MD · Medical Physician Assistant in Maryland

Sources for this page

Verify at the official NPI Registry.