Healthcare Provider Details

I. General information

NPI: 1497241582
Provider Name (Legal Business Name): BETHESDA CHEVY CHASE ORTHOPAEDIC ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2018
Last Update Date: 09/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1635 N GEORGE MASON DR STE 180
ARLINGTON VA
22205-3633
US

IV. Provider business mailing address

10215 FERNWOOD RD STE 506
BETHESDA MD
20817-1184
US

V. Phone/Fax

Practice location:
  • Phone: 301-530-1010
  • Fax:
Mailing address:
  • Phone: 301-530-1010
  • Fax: 301-897-8597

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: CHUCK GRASMEDER
Title or Position: CHIEF ADMINISTRATIVE OFFICER
Credential:
Phone: 240-482-2412