Healthcare Provider Details

I. General information

NPI: 1720238587
Provider Name (Legal Business Name): ERIC A. ORISTIAN, MD, P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2008
Last Update Date: 09/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2730 UNIVERSITY BLVD W STE 216
WHEATON MD
20902-1905
US

IV. Provider business mailing address

2730 UNIVERSITY BLVD W STE 216
WHEATON MD
20902-1905
US

V. Phone/Fax

Practice location:
  • Phone: 301-942-4080
  • Fax: 301-942-4082
Mailing address:
  • Phone: 301-942-4080
  • Fax: 301-942-4082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LAURIE ORISTIAN
Title or Position: OFFICE MANAGER
Credential:
Phone: 301-942-4080