Internal Medicine Practice, P.a.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

INTERNAL MEDICINE PRACTICE, P.A.

Practice address

324 E Antietam St Ste 306
Hagerstown, MD 21740-5768

Phone

(301) 739-0240

Fax

(301) 797-8546

NPI assigned

Sep 29, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Koduah Peprah, M.D.NPI 1861584591

Title

Director

Phone

(301) 996-7900

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Koduah Peprah, M.D.

  • Internal Medicine Physician
  • Hagerstown, MD
  • NPI 1861584591
  Medicare reassignment Care Compare group NPD Authorized official
• Richard Yaw Koduah, M.D

  • Internal Medicine Physician
  • Cheverly, MD
  • NPI 1609034628
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328486400000",
    "number": "1336231950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18300 THUNDERCLOUD RD",
            "city": "BOYDS",
            "state": "MD",
            "postal_code": "208414380",
            "telephone_number": "301-540-2076",
            "fax_number": "301-540-5073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 E ANTIETAM ST STE 306",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405768",
            "telephone_number": "301-739-0240",
            "fax_number": "301-797-8546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE PRACTICE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2012-02-06",
        "status": "A",
        "authorized_official_last_name": "PEPRAH",
        "authorized_official_first_name": "KODUAH",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "301-996-7900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "336619700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Innovative Therapeutic Services, Corp.
• Institute for Family Centered Services Inc
• Institute for Family Centered Services Inc
• Integrative Medicine Center. LLC
• Internal Medicine Consultation Services, LLC
• Interstate Psychaitric Care
• Anwar Iqbal, MD
• Shaheen Iqbal, MD
• Amanda Isard
• Shaila Lillielouise Isham

• Primary Care Clinic/Center in Hagerstown, MD
• Providers in Hagerstown, MD by specialty
• Primary Care Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.