Provider Demographics
NPI:1467328864
Name:PRIMECARE INTERNAL MEDICINE ASSOCIATE, LLC
Entity type:Organization
Organization Name:PRIMECARE INTERNAL MEDICINE ASSOCIATE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:MBEBOH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-850-2323
Mailing Address - Street 1:2059 BALTIMORE BLVD
Mailing Address - Street 2:
Mailing Address - City:FINKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21048-1301
Mailing Address - Country:US
Mailing Address - Phone:443-850-2323
Mailing Address - Fax:410-941-2766
Practice Address - Street 1:2059 BALTIMORE BLVD
Practice Address - Street 2:
Practice Address - City:FINKSBURG
Practice Address - State:MD
Practice Address - Zip Code:21048-1301
Practice Address - Country:US
Practice Address - Phone:443-850-2323
Practice Address - Fax:410-941-2766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-13
Last Update Date:2025-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty