Healthcare Provider Details
I. General information
NPI: 1184452278
Provider Name (Legal Business Name): CAPITAL DIABETES & ENDOCRINE ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/22/2024
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2101 MEDICAL PARK DR STE 211
SILVER SPRING MD
20902-4053
US
IV. Provider business mailing address
5801 ALLENTOWN RD STE 500
CAMP SPRINGS MD
20746-4518
US
V. Phone/Fax
- Phone: 301-899-7713
- Fax:
- Phone: 301-899-7713
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RE0101X |
| Taxonomy | Endocrinology, Diabetes & Metabolism Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROMEU
MANUEL
AZEVEDO
Title or Position: PRESIDENT
Credential: MD
Phone: 301-899-7713