Healthcare Provider Details

I. General information

NPI: 1538049200
Provider Name (Legal Business Name): ALCHEMY VEIN SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2025
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6830 HOSPITAL DR STE 110
ROSEDALE MD
21237-4375
US

IV. Provider business mailing address

6830 HOSPITAL DR STE 110
ROSEDALE MD
21237-4375
US

V. Phone/Fax

Practice location:
  • Phone: 202-539-4334
  • Fax:
Mailing address:
  • Phone: 202-539-4334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: KRYSTAL ALCOTT
Title or Position: PA-C
Credential:
Phone: 202-539-4334