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General NPI Number Information
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NPI Number | 1174130454
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Entity Type | Organization
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Legal Business Name | CAPITAL RADIOSURGERY CENTERS LLC
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Dates
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Enumeration Date | 09/30/2020
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Last Update Date | 09/30/2020
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Provider Practice Location Address
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Address Line | 3730 COMMERCE DR STE 12141217
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City | BALTIMORE
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State | MD
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Zip | 21227-1654
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Country | US
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Telephone | 404-480-4658
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Fax | 607-324-7615
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Provider Business Mailing Address
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Address Line | 3730 COMMERCE DR STE 12141217
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City | BALTIMORE
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State | MD
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Zip | 21227-1654
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Country | US
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Telephone | 404-480-4658
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Fax | 607-324-7615
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Authorized Official
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Title or Position | CHIEF OPERATIONS OFFICER
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Name | PAUL BOWERS
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Credential |
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Telephone | 404-480-4658
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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