MEDICARE: ADVANCED CARDIOVASCULAR INSTITUTE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician
2	207RI0011X	Interventional Cardiology Physician

General Provider Information

NPI Number	:	1255899621
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED CARDIOVASCULAR INSTITUTE

Provider Business Mailing Address
First Line	:	12120 PLUM ORCHARD DR STE 150
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-7820
Country	:	US
Telephone Number	:	301-755-6500
Fax Number	:	240-345-9227

Provider Business Practice Location Address
First Line	:	12120 PLUM ORCHARD DR STE 150
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-7820
Country	:	US
Telephone Number	:	301-755-6500
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	ISAAC OPOKU-ASARE
Credential	:	MD
Telephone Number	:	301-755-6500

Provider Enumeration Date	:	03/05/2019
Last Update Date	:	07/30/2022

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Directions to “ADVANCED CARDIOVASCULAR INSTITUTE ” Practice Location

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