Provider Demographics
NPI:1154039162
Name:MORAYO MEDICAL LLC
Entity type:Organization
Organization Name:MORAYO MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:OSHODI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-674-2576
Mailing Address - Street 1:2702 SWANN WING CT
Mailing Address - Street 2:
Mailing Address - City:GLENARDEN
Mailing Address - State:MD
Mailing Address - Zip Code:20706-1683
Mailing Address - Country:US
Mailing Address - Phone:202-674-2576
Mailing Address - Fax:
Practice Address - Street 1:12200 ANNAPOLIS RD STE 324
Practice Address - Street 2:
Practice Address - City:GLENN DALE
Practice Address - State:MD
Practice Address - Zip Code:20769-9184
Practice Address - Country:US
Practice Address - Phone:301-291-7077
Practice Address - Fax:301-291-7073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-08
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty