Healthcare Provider Details

I. General information

NPI: 1619638954
Provider Name (Legal Business Name): CAPITAL INTERVENTIONAL PAIN & SPINE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2022
Last Update Date: 01/08/2022
Certification Date: 01/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3204 TOWER OAKS BLVD STE 440
ROCKVILLE MD
20852-4250
US

IV. Provider business mailing address

9006 EWING DR
BETHESDA MD
20817-3358
US

V. Phone/Fax

Practice location:
  • Phone: 301-841-6600
  • Fax: 301-841-6500
Mailing address:
  • Phone: 301-841-6600
  • Fax: 301-841-6500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. AKSHAY GARG
Title or Position: PHYSICIAN OWNER
Credential: MD
Phone: 301-841-6600