Healthcare Provider Details

I. General information

NPI: 1033456900
Provider Name (Legal Business Name): CARDIOLOGY ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2013
Last Update Date: 01/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2670 CRAIN HWY SUITE 300
WALDORF MD
20601-2806
US

IV. Provider business mailing address

106 IRVING ST NW SUITE 2700N
WASHINGTON DC
20010-2927
US

V. Phone/Fax

Practice location:
  • Phone: 301-632-5750
  • Fax: 301-632-5755
Mailing address:
  • Phone: 202-723-5524
  • Fax: 202-291-0512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MICHELE FRYMOYER
Title or Position: VP OF OPERATIONS
Credential:
Phone: 202-723-5524