Healthcare Provider Details

I. General information

NPI: 1336589431
Provider Name (Legal Business Name): CAPITAL ORTHOPAEDIC SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2013
Last Update Date: 04/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7501 SURRATTS RD STE 110
CLINTON MD
20735-3362
US

IV. Provider business mailing address

7404 EXECUTIVE PL STE 300B
LANHAM MD
20706-2268
US

V. Phone/Fax

Practice location:
  • Phone: 240-842-1434
  • Fax: 301-868-5443
Mailing address:
  • Phone: 301-599-9500
  • Fax: 301-856-7685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDX3601
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number20583
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number03020
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number06970
License Number StateMD
# 5
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberD0000407
License Number StateMD

VIII. Authorized Official

Name: DR. JOSEPH T CROWE
Title or Position: DIRECTOR
Credential: MD
Phone: 301-599-1000