Healthcare Provider Details

I. General information

NPI: 1194794198
Provider Name (Legal Business Name): CARDIAC CONSULTANTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 12/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

888 BESTGATE RD SUITE 211
ANNAPOLIS MD
21401-3091
US

IV. Provider business mailing address

PO BOX 62076
BALTIMORE MD
21264-2076
US

V. Phone/Fax

Practice location:
  • Phone: 410-897-9474
  • Fax: 410-897-9476
Mailing address:
  • Phone: 410-280-6577
  • Fax: 410-280-6515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LOUIS ESSANDOH
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 410-897-9474