Healthcare Provider Details

I. General information

NPI: 1053791855
Provider Name (Legal Business Name): CAPITAL ORTHOPAEDIC SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2015
Last Update Date: 12/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8100 GOOD LUCK RD
LANHAM MD
20706-3500
US

IV. Provider business mailing address

8100 GOOD LUCK RD
LANHAM MD
20706-3500
US

V. Phone/Fax

Practice location:
  • Phone: 240-965-8410
  • Fax: 240-965-8416
Mailing address:
  • Phone: 240-965-8410
  • Fax: 240-965-8416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberD0022407
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number04923
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number06902
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberD0022407
License Number StateMD

VIII. Authorized Official

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