Healthcare Provider Details

I. General information

NPI: 1972976231
Provider Name (Legal Business Name): CAPITAL HEALTHCARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2015
Last Update Date: 01/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8305 WISCONSIN AVE
BETHESDA MD
20814-3103
US

IV. Provider business mailing address

6020 RICHMOND HWY
ALEXANDRIA VA
22303-2157
US

V. Phone/Fax

Practice location:
  • Phone: 301-800-7000
  • Fax:
Mailing address:
  • Phone: 571-308-6776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GEVORG SEDRAKYAN
Title or Position: DIRECTOR
Credential: MD
Phone: 267-978-1993