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General NPI Number Information
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NPI Number | 1508901422
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Entity Type | Organization
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Legal Business Name | CANCER QUALITY CARE LLC
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 11/01/2007
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Provider Practice Location Address
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Address Line | 4416 E WEST HWY STE 410
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City | BETHESDA
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State | MD
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Zip | 20814-4568
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Country | US
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Telephone | 301-493-0400
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Fax | 301-493-0037
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Provider Business Mailing Address
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Address Line | PO BOX 34975
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City | BETHESDA
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State | MD
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Zip | 20827-0975
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Country | US
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Telephone | 301-493-0400
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Fax | 301-493-0037
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Authorized Official
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Title or Position | OWNER
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Name | GISELLE MERY
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Credential | MD
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Telephone | 301-493-0400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | M54084
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License Number State | MD
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