Provider Demographics
NPI:1841617941
Name:PRIMARY MEDICINE LLC
Entity type:Organization
Organization Name:PRIMARY MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAVEH
Authorized Official - Middle Name:
Authorized Official - Last Name:SADEGHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-498-9494
Mailing Address - Street 1:PO BOX 2510
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20709-2510
Mailing Address - Country:US
Mailing Address - Phone:301-498-9494
Mailing Address - Fax:301-498-6301
Practice Address - Street 1:14113 BALTIMORE AVE STE A
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5073
Practice Address - Country:US
Practice Address - Phone:301-498-9494
Practice Address - Fax:301-498-6301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-26
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty