Healthcare Provider Details
I. General information
NPI: 1194961672
Provider Name (Legal Business Name): WASHINGTON METROPOLITAN CARDIOLOGY, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/05/2009
Last Update Date: 01/05/2009
Certification Date: WASHINGTON METROPOLITAN CARDIOLOGY, INC 611 S CARLIN SPRINGS RD ARLINGTON VA 22204 611 S CARLIN SPRINGS RD ARLINGTON VA 22204
Deactivation Date:
Reactivation Date:
III. Provider practice location address
611 S CARLIN SPRINGS RD SUITE 201
ARLINGTON VA
22204-1064
US
IV. Provider business mailing address
611 S CARLIN SPRINGS RD SUITE 201
ARLINGTON VA
22204-1064
US
V. Phone/Fax
- Phone: 703-933-0700
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease |
| License Number | 0101052178 |
| License Number State | VA |
VIII. Authorized Official
Name:
HASTANA
RASOULY
Title or Position: OFFICE MANAGER
Credential:
Phone: 703-933-0700