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General NPI Number Information
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NPI Number | 1104664648
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Entity Type | Organization
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Legal Business Name | CAPITAL DIGESTIVE CARE, LLC
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Dates
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Enumeration Date | 07/18/2024
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Last Update Date | 12/22/2025
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Provider Practice Location Address
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Address Line | 6230 OLD DOBBIN LN STE 150
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City | COLUMBIA
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State | MD
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Zip | 21045-5809
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Country | US
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Telephone | 410-730-9363
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Fax | 410-730-2084
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Provider Business Mailing Address
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Address Line | 10770 COLUMBIA PIKE STE 400
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City | SILVER SPRING
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State | MD
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Zip | 20901-4462
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Country | US
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Telephone | 240-485-5200
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Fax | 301-576-8456
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Authorized Official
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Title or Position | CEO
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Name | TIMOTHY SHORT
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Credential |
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Telephone | 757-803-6483
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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