Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Type 1 Individual Provider

Organization Exclusive Provider Organization · NPI 1952543191

Type 1 Individual Provider is an Exclusive Provider Organization in Silver Spring, Maryland. Licensed in Maryland. Registered with an NPI since 2009.

Licensed in
MD
In the registry since
2009

Practice location Address checks out

1620 Elton Rd
Silver Spring, MD 20903-1740
Phone: (301) 439-7191
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Exclusive Provider Organization (primary) Taxonomy 302F00000X · Licence LC2381 (MD)

Record details

NPI number1952543191
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Brena Gibson — Human Resources Director · (301) 439-7191
Other names Type 1 Individual Provider
NPI enumeratedApril 2, 2009
Last updated in NPPESApril 8, 2009
Mailing address1620 Elton Rd, Silver Spring, MD 20903-1740

Other providers in Silver Spring