Provider Demographics
NPI:1750910543
Name:PRIORITY MED GROUP
Entity type:Organization
Organization Name:PRIORITY MED GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:GANG
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:301-408-8987
Mailing Address - Street 1:13000 BROOKMILL CT
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-2350
Mailing Address - Country:US
Mailing Address - Phone:301-408-8987
Mailing Address - Fax:
Practice Address - Street 1:13000 BROOKMILL CT
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-2350
Practice Address - Country:US
Practice Address - Phone:301-408-8987
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-03
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty