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General NPI Number Information
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NPI Number | 1497947048
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Entity Type | Organization
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Legal Business Name | ANNAPOLIS-BOWIE CARDIOVASCULAR PC
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Dates
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Enumeration Date | 08/16/2007
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Last Update Date | 02/05/2008
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Provider Practice Location Address
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Address Line | 1204 WEST ST
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City | ANNAPOLIS
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State | MD
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Zip | 21401-3610
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Country | US
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Telephone | 410-263-0799
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Fax | 410-263-4021
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Provider Business Mailing Address
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Address Line | 1204 WEST ST
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City | ANNAPOLIS
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State | MD
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Zip | 21401-3610
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Country | US
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Telephone | 410-263-0799
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Fax | 410-263-4021
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. HECTOR KLOTEY COLLISON
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Credential | MD
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Telephone | 410-263-0799
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | D0026765
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License Number State | MD
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