Collaboration Agreement No:
3779
Confirmation No:
3779_1786C0004941
Section 1 - Physician Assistant Information
Confidential Information redacted.
Section 2 - Primary Practice Setting & Location:
Practice Type:
Urgent Care-Patient First
Facility
Patient First: UC in Beltsville
Address
10424 Baltimore Avenue
Beltsville
MD 20705
Is this the location where a copy of your collaboration agreement is on file? NO
A copy (paper or electronic) must be immediately available upon request by the Board.
Location: Patient First Admin Office, 5000 Cox Road, Glenn Allen, VA 23060
Section 3 - Advanced Duties and Prescriptive and Dispensing Authority
1.Does this Collaboration Agreement include Advanced Duties?
NO
2. Does this Collaboration Agreement include prescriptive authority?
YES
3. Does this Collaboration Agreement include dispensing authority under a physician's active dispensing permit?
YES
Physician's Name: Dr. Paul Wu | License No: D0067619