LEGACY MEDICAL CLINIC WITH MENTAL HEALTH, LLC - NPI 1912518952

Q: What is Legacy Medical Clinic With Mental Health, LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

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About Legacy Medical Clinic With Mental Health, Llc NPPES

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

LEGACY MEDICAL CLINIC WITH MENTAL HEALTH, LLC (NPI 1912518952) is a healthcare organization registered as a psychiatric/mental health in Temple Hills, Maryland and active in the NPI registry since August 2020. The organization lists Chuks E Nwaulu, Owner Of The Entity, as its authorized official.

NPPES Registry Identity

NPI1912518952

Entity TypeOrganization

Primary Taxonomy363LP0808X

Legal Business NameLEGACY MEDICAL CLINIC WITH MENTAL HEALTH, LLC

Location Address4700 STAMP RD STE KTemple Hills, MD 20748-6717

Mailing Address9509 Manor Oaks VwUpper Marlboro, MD 20772-3192 · (301) 880-4900 · Fax (301) 477-4673

Phone(301) 880-4900

Fax(301) 477-4673

Organization SubpartNo

Authorized OfficialChuks E NwauluOwner Of The Entity · (301) 880-4900

Enumeration DateAugust 13, 2020

NPPES CertifiedAugust 13, 2020

✔ NPI 1912518952 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

4700 STAMP RD STE K, Temple Hills, MD 20748

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 5

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

UZOCHIAMAKA NDUKWU

Nurse Practitioner (Psychiatric/Mental Health)