Healthcare Provider Details

I. General information

NPI: 1295078046
Provider Name (Legal Business Name): METRO DIRECT CARE MEDICAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2013
Last Update Date: 03/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 WISCONSIN CIR STE 700
CHEVY CHASE MD
20815-7007
US

IV. Provider business mailing address

2 WISCONSIN CIR STE 700
CHEVY CHASE MD
20815-7007
US

V. Phone/Fax

Practice location:
  • Phone: 202-368-6820
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PATRICK LODISE
Title or Position: OPERATIONS MANAGER
Credential:
Phone: 202-368-6820