Healthcare Provider Details

I. General information

NPI: 1417294380
Provider Name (Legal Business Name): CARDIOLOGY ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2013
Last Update Date: 01/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25500 POINT LOOKOUT RD SUITE P250
LEONARDTOWN MD
20650-2015
US

IV. Provider business mailing address

106 IRVING ST NW SUITE 2700N
WASHINGTON DC
20010-2927
US

V. Phone/Fax

Practice location:
  • Phone: 240-434-4070
  • Fax: 240-434-4071
Mailing address:
  • Phone: 202-723-5524
  • Fax: 202-291-0512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MICHELE FRYMOYER
Title or Position: VP OF OPERATIONS
Credential:
Phone: 202-723-5524