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NPI 1104170182ActiveOrganization· Preferred Provider Organization· Takoma Park, MD

Preferred Provider Organization in Takoma Park, Maryland, registered in NPPES in October 2012. The authorized official on file is Terrance Ambe, Ceo.

Overview

NPI1104170182
StatusActive
Entity typeOrganization
NPI issuedOct 30, 2012
Last updated in NPPESOct 30, 2012

Specialties and licenses

TaxonomyCodeLicenseState
Preferred Provider Organization Primary305R00000X——

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Nov 10, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 11, 2026No match—
New York OMIG · Nov 11, 2026No match—
Ohio Medicaid · Nov 11, 2026No match—
Pennsylvania Medicheck · Nov 11, 2026No match—
Washington HCA · Nov 11, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Not in the public enrollment file of Oct 1, 2026

Medicare sources and data years

Other Preferred Provider Organization providers in Takoma Park

All Preferred Provider Organization providers in Maryland →