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General NPI Number Information
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NPI Number | 1114206802
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Entity Type | Organization
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Legal Business Name | PREMIER CARDIOVASCULAR CARE LLC
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Dates
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Enumeration Date | 08/11/2011
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Last Update Date | 08/11/2011
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Provider Practice Location Address
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Address Line | 10756 RHODE ISLAND AVE
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City | BELTSVILLE
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State | MD
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Zip | 20705-2513
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Country | US
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Telephone | 301-595-0356
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Fax | 301-595-0359
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Provider Business Mailing Address
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Address Line | 2417 NICOL CIR
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City | MITCHELLVILLE
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State | MD
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Zip | 20721-2907
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Country | US
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Telephone | 240-678-3751
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SAIFUDIN A HUSSEIN
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Credential | M.D.
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Telephone | 301-595-0356
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | D0063586
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License Number State | MD
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