Provider Demographics
NPI:1063169225
Name:TOTAL WELLNESS & HEALTH CENTER INC
Entity type:Organization
Organization Name:TOTAL WELLNESS & HEALTH CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:YETUNDE
Authorized Official - Middle Name:
Authorized Official - Last Name:SANNOH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-870-7275
Mailing Address - Street 1:9550 MARLBORO PIKE
Mailing Address - Street 2:SUITE # 12
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-3766
Mailing Address - Country:US
Mailing Address - Phone:301-494-1006
Mailing Address - Fax:
Practice Address - Street 1:9500 MARLBORO PIKE STE 12
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-3766
Practice Address - Country:US
Practice Address - Phone:301-494-1006
Practice Address - Fax:301-494-1006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-08
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD0075522OtherSTATE LICENSE