Healthcare Provider Details

I. General information

NPI: 1619361797
Provider Name (Legal Business Name): EDVARDAS KAMINSKAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2015
Last Update Date: 03/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10903 NEW HAMPSHIRE AVE BLDG. 22, RM. 2372
SILVER SPRING MD
20903-1058
US

IV. Provider business mailing address

10903 NEW HAMPSHIRE AVE BLDG. 22, RM. 2372
SILVER SPRING MD
20903-1058
US

V. Phone/Fax

Practice location:
  • Phone: 301-796-1383
  • Fax:
Mailing address:
  • Phone: 301-796-1383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number29734
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number29734
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: