Healthcare Provider Details

I. General information

NPI: 1346905437
Provider Name (Legal Business Name): WASHINGTON VASCULAR SPECIALISTS OF BALTIMORE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2021
Last Update Date: 11/03/2021
Certification Date: 11/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 W CAMDEN ST STE 201
BALTIMORE MD
21201-7912
US

IV. Provider business mailing address

15245 SHADY GROVE RD STE 325N
ROCKVILLE MD
20850-3222
US

V. Phone/Fax

Practice location:
  • Phone: 410-541-7800
  • Fax: 410-541-7900
Mailing address:
  • Phone: 301-891-2500
  • Fax: 301-448-1679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

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