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General NPI Number Information
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NPI Number | 1497380968
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Entity Type | Organization
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Legal Business Name | EMBRIEL LLC
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Dates
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Enumeration Date | 03/05/2020
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Last Update Date | 03/05/2020
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Provider Practice Location Address
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Address Line | 6500 ROCK SPRING DR STE 100
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City | BETHESDA
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State | MD
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Zip | 20817-1182
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Country | US
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Telephone | 240-320-6521
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Fax |
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Provider Business Mailing Address
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Address Line | 7512 OYSTER BAY WAY
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City | GAITHERSBURG
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State | MD
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Zip | 20886-5907
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Country | US
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Telephone | 240-320-6521
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Fax |
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Authorized Official
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Title or Position | SURGICAL FIRST ASSIST
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Name | GEM Y WALKER LAWSON
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Credential | CFA
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Telephone | 240-320-6521
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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