Healthcare Provider Details
I. General information
NPI: 1023812245
Provider Name (Legal Business Name): HEARTMASTERS MEDICAL ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/04/2025
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1810 BENNING RD NE
WASHINGTON DC
20002-7253
US
IV. Provider business mailing address
PO BOX 3786
CROFTON MD
21114-3786
US
V. Phone/Fax
- Phone: 202-669-5821
- Fax:
- Phone: 202-669-5821
- Fax: 301-877-6963
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QH0100X |
| Taxonomy | Health Service Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM2500X |
| Taxonomy | Medical Specialty Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
IEON
LLOYD
DAWSON
Title or Position: CARDIOLOGIST /PRESIDENT
Credential: MD
Phone: 202-669-5821