Healthcare Provider Details

I. General information

NPI: 1265962583
Provider Name (Legal Business Name): CAPITAL ORTHOPAEDIC SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2017
Last Update Date: 06/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5801 ALLENTOWN RD STE 200
SUITLAND MD
20746-4561
US

IV. Provider business mailing address

PO BOX 418871
BOSTON MA
02241-8871
US

V. Phone/Fax

Practice location:
  • Phone: 301-599-9500
  • Fax: 877-925-7211
Mailing address:
  • Phone: 301-599-9500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number20838
License Number StateMD

VIII. Authorized Official

Name: MS. CAMILLE R BASH
Title or Position: CFO
Credential:
Phone: 301-552-8028