Provider Demographics
NPI:1932338357
Name:COMMUNITY FAMILY MEDICINE PC
Entity type:Organization
Organization Name:COMMUNITY FAMILY MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:EPSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-984-8689
Mailing Address - Street 1:121 CONGRESSIONAL LN
Mailing Address - Street 2:SUITE 318
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-1542
Mailing Address - Country:US
Mailing Address - Phone:301-984-8689
Mailing Address - Fax:301-984-4843
Practice Address - Street 1:121 CONGRESSIONAL LN
Practice Address - Street 2:SUITE 318
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1542
Practice Address - Country:US
Practice Address - Phone:301-984-8689
Practice Address - Fax:301-984-4843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-07
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty