KRYSTAL MEDICAL ASSOCIATES
NPI 1164604187
Clinic/Center - Primary Care in Glenn Dale, MD

Active since November 30, 2007
12150 ANNAPOLIS RD, SUITE 100, GLENN DALE, MD 20769(301) 464-7601(866) 885-9817 Get Directions Write a Review

NPPES record last updated: August 18, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Krystal Medical Associates NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KRYSTAL MEDICAL ASSOCIATES (NPI 1164604187) is a healthcare organization registered as a primary care in Glenn Dale, Maryland and active in the NPI registry since November 2007. The organization lists Nwaehihie H Onyeaghala, President, as its authorized official.

NPPES Registry Identity

NPI1164604187
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameKRYSTAL MEDICAL ASSOCIATES LLC
Location Address12150 ANNAPOLIS RD, SUITE 100Glenn Dale, MD 20769-9183
Mailing Address12150 Annapolis Rd, Suite 100Glenn Dale, MD 20769-9183 · (301) 464-7601
Fax(866) 885-9817
Organization SubpartNo
Authorized OfficialNwaehihie H OnyeaghalaPresident · (301) 486-0100
Enumeration DateNovember 30, 2007
Last NPPES UpdateAugust 18, 2014
NPI 1164604187 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License Licensed in MD · D0053461
Also ListedClinic/Center · Multi-SpecialtyTaxonomy 261QM1300X · License D0053461 (MD)
12150 ANNAPOLIS RD, Glenn Dale, MD 20769

Other Names 1

Doing Business AsKrystal Medical Associates

Other Identifiers 3

Medicaid010012902VA
Medicaid402647100MD
Medicaid034934800DC

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Specialist
12150 ANNAPOLIS RD, SUITE #108
GLENN DALE, MD 20769
Nurse Practitioner
12150 ANNAPOLIS RD, SUITE 108
GLENN DALE, MD 20769
General Practice
12150 ANNAPOLIS RD, SUITE 100
GLENN DALE, MD 20769
Internal Medicine
12150 ANNAPOLIS RD, SUITE 308
GLENN DALE, MD 20769
Surgery
12150 ANNAPOLIS RD, SUITE 309
GLENN DALE, MD 20769
Dentist (General Practice)
12150 ANNAPOLIS RD, SUITE301
GLENN DALE, MD 20769
Orthopaedic Surgery
12150 ANNAPOLIS RD, SUITE 305
GLENN DALE, MD 20769
Internal Medicine
12150 ANNAPOLIS RD, SUITE 205
GLENN DALE, MD 20769

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Krystal Medical Associates LLC's NPI number?

The NPI number for Krystal Medical Associates LLC is 1164604187. It was assigned to this organization in the NPPES registry on November 30, 2007. The provider is doing business as Krystal Medical Associates.

Where is Krystal Medical Associates LLC located?

Krystal Medical Associates LLC is located at 12150 Annapolis Rd Suite 100, Glenn Dale, MD 20769. The listed phone number is (301) 464-7601.

What is Krystal Medical Associates LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

When was this NPI record last updated?

The NPPES record for Krystal Medical Associates LLC was last updated on August 18, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.