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Civista Clinical Services Llc
Multi-Specialty Clinic/Center in Waldorf, Maryland
NPI 1831417476

Civista Clinical Services Llc is a Multi-Specialty Clinic/Center based in La Plata, MD and is specialized in Multi-Specialty. Civista Clinical Services Llc practices in Waldorf, MD. The NPI Number for Civista Clinical Services Llc is 1831417476 and holds a License No. D0065304 (Maryland).

The current practice location address for Civista Clinical Services Llc is 11315 Pembrooke Sq Ste 111, Waldorf, MD and can be reached out via phone at 301-843-3150 and via fax at 301-843-2560.

Location: 11315 Pembrooke Sq Ste 111, Waldorf, MD, 20646-1070
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1831417476
Provider Name
Civista Clinical Services Llc
Credential
Provider Entity Type
Organization
Address
11315 Pembrooke Sq Ste 111, Waldorf, MD, 20646-1070
Phone Number
301-843-3150
Fax Number
301-843-2560
Provider Enumeration Date
05/06/2010
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
11315 Pembrooke Sq Ste 111
City
Waldorf
State
Maryland
Zip
20603-4806
Phone Number
301-843-3150
Fax Number
301-843-2560
person
Provider Business Mailing Address Details
Address
11315 Pembrooke Sq Ste 111
City
Waldorf
State
Maryland
Zip
20603-4806
Phone Number
301-843-3150
Fax Number
301-843-2560
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Multi-Specialty
Taxonomy
261QM1300X
License No.
D0065304 (Maryland)
Definition
Definition to come...
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