Healthcare Provider Details

I. General information

NPI: 1801014907
Provider Name (Legal Business Name): MEDISPEC LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 01/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20410 OBSERVATION DR SUITE 102
GERMANTOWN MD
20876-4000
US

IV. Provider business mailing address

20410 OBSERVATION DR SUITE 102
GERMANTOWN MD
20876-4000
US

V. Phone/Fax

Practice location:
  • Phone: 301-944-1575
  • Fax: 301-972-6098
Mailing address:
  • Phone: 301-944-1575
  • Fax: 301-972-6098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QL0400X
TaxonomyLithotripsy Clinic/Center
License NumberM342R
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. ANIL DHINGRA
Title or Position: VICE PRESIDENT & COO
Credential:
Phone: 301-944-1575