Healthcare Provider Details

I. General information

NPI: 1366293136
Provider Name (Legal Business Name): WASHINGTON CARDIOVASCULAR INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2024
Last Update Date: 03/29/2024
Certification Date: 03/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2041 MARTIN LUTHER KING JR AVE SE STE 103
WASHINGTON DC
20020-7033
US

IV. Provider business mailing address

2041 MARTIN LUTHER KING JR AVE SE STE 103
WASHINGTON DC
20020-7033
US

V. Phone/Fax

Practice location:
  • Phone: 301-927-3668
  • Fax:
Mailing address:
  • Phone: 301-927-3668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MUBASHAR A CHOUDRY
Title or Position: OWNER
Credential: MD
Phone: 301-891-2500