Healthcare Provider Details

I. General information

NPI: 1578509006
Provider Name (Legal Business Name): CAPITAL AREA ORTHOPEDIC ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 03/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 NORTH LA PLATA COURT
LA PLATA MD
20646
US

IV. Provider business mailing address

PO BOX 2188
LA PLATA MD
20646-2188
US

V. Phone/Fax

Practice location:
  • Phone: 301-392-3330
  • Fax: 301-392-3950
Mailing address:
  • Phone: 301-392-3330
  • Fax: 301-392-3950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number StateMD

VIII. Authorized Official

Name: DR. GREGG ALAN FERRERO
Title or Position: ORTHOPEDIC SURGEON/MEDICAL DIRECTOR
Credential: M.D.
Phone: 301-392-3330