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General NPI Number Information
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NPI Number | 1558764308
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Entity Type | Organization
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Legal Business Name | CAPITOL VASCULAR CARE PLLC
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Dates
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Enumeration Date | 10/07/2014
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Last Update Date | 12/15/2014
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Provider Practice Location Address
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Address Line | 2311 M ST NW SUITE 501
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City | WASHINGTON
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State | DC
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Zip | 20037-1445
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Country | US
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Telephone | 202-587-2766
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Fax |
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Provider Business Mailing Address
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Address Line | 2311 M ST NW SUITE 501
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City | WASHINGTON
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State | DC
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Zip | 20037-1445
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Country | US
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Telephone | 202-587-2766
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. JOHN J RICOTTA
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Credential | MD
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Telephone | 202-265-0605
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | MD037679
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License Number State | DC
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