Healthcare Provider Details

I. General information

NPI: 1437149713
Provider Name (Legal Business Name): CARLOS A GARCIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 10/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 IRVING ST NW BB-43
WASHINGTON DC
20010-3017
US

IV. Provider business mailing address

1201 SEVEN LOCKS RD SUITE 200
ROCKVILLE MD
20854-2931
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-6066
  • Fax: 202-877-6601
Mailing address:
  • Phone: 301-652-5771
  • Fax: 301-652-6332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License NumberMD034310
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: