Healthcare Provider Details

I. General information

NPI: 1609362813
Provider Name (Legal Business Name): AXIS HEALTHCARE GROUP, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2018
Last Update Date: 01/11/2024
Certification Date: 01/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8040 GEORGIA AVE STE 170
SILVER SPRING MD
20910-4959
US

IV. Provider business mailing address

8040 GEORGIA AVE STE 170
SILVER SPRING MD
20910-4959
US

V. Phone/Fax

Practice location:
  • Phone: 202-360-4787
  • Fax:
Mailing address:
  • Phone: 202-360-4787
  • Fax: 202-360-4787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: JUDE ALEXANDER
Title or Position: PRESIDENT
Credential:
Phone: 202-360-4787