Healthcare Provider Details

I. General information

NPI: 1861986572
Provider Name (Legal Business Name): ACCESSIBLE INTEGRATIVE MEDICINE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2018
Last Update Date: 08/06/2024
Certification Date: 08/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 COURTHOUSE SQ STE 204
ROCKVILLE MD
20850-2338
US

IV. Provider business mailing address

20 COURTHOUSE SQ STE 204
ROCKVILLE MD
20850-2338
US

V. Phone/Fax

Practice location:
  • Phone: 301-962-4278
  • Fax:
Mailing address:
  • Phone: 301-962-4278
  • Fax: 833-781-1112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberD0075394
License Number StateMD

VIII. Authorized Official

Name: DR. ALAN GONZALEZ COTA
Title or Position: MEDICAL OFFICER
Credential: MD
Phone: 301-962-4278