Healthcare Provider Details

I. General information

NPI: 1205605342
Provider Name (Legal Business Name): WASHINGTON CARDIOVASCULAR INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/01/2024
Last Update Date: 06/17/2024
Certification Date: 06/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7610 CARROLL AVE STE 210
TAKOMA PARK MD
20912-6312
US

IV. Provider business mailing address

7610 CARROLL AVE STE 210
TAKOMA PARK MD
20912-6312
US

V. Phone/Fax

Practice location:
  • Phone: 301-891-2500
  • Fax: 301-448-1679
Mailing address:
  • Phone: 301-891-2500
  • Fax: 301-448-1679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MUBASHAR A CHOUDRY
Title or Position: OWNER
Credential: MD
Phone: 301-891-2500