Healthcare Provider Details

I. General information

NPI: 1609547751
Provider Name (Legal Business Name): MARYLAND CARDIAC CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2021
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9715 MEDICAL CENTER DR STE 202
ROCKVILLE MD
20850-6305
US

IV. Provider business mailing address

9715 MEDICAL CENTER DR STE 202
ROCKVILLE MD
20850-6305
US

V. Phone/Fax

Practice location:
  • Phone: 301-337-9766
  • Fax:
Mailing address:
  • Phone: 301-337-9766
  • Fax: 240-715-9125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: THOMAS H. WANG
Title or Position: CEO
Credential: MD
Phone: 301-337-9766