Healthcare Provider Details
I. General information
NPI: 1689971004
Provider Name (Legal Business Name): CARDIOLOGY ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/21/2011
Last Update Date: 02/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
18109 PRINCE PHILIP DR SUITE 225
OLNEY MD
20832-1519
US
IV. Provider business mailing address
106 IRVING ST NW SUITE 2700N
WASHINGTON DC
20010-2927
US
V. Phone/Fax
- Phone: 301-774-5810
- Fax:
- Phone: 202-723-5524
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHELE
FRYMOYER
Title or Position: VICE PRESIDENT OF OPERATIONS
Credential:
Phone: 202-723-5524