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NPI 1639023856

NPI 1639023856 : MARYLAND INTERVENTIONAL INSTITUTE, LLC : BETHESDA, MD

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General NPI Number Information
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    NPI Number           |    1639023856
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    Entity Type          |    Organization 
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    Legal Business Name  |    MARYLAND INTERVENTIONAL INSTITUTE, LLC 
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Dates
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    Enumeration Date     |    02/24/2026
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    Last Update Date     |    02/24/2026
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Provider Practice Location Address
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    Address Line         |    5920 BRADLEY BLVD 
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    City                 |    BETHESDA
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    State                |    MD
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    Zip                  |    20814-1107
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    Country              |    US
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    Telephone            |    770-953-2600
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3670 HIGHLANDS PKWY SE 
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    City                 |    SMYRNA
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    State                |    GA
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    Zip                  |    30082-5184
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    Country              |    US
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    Telephone            |    770-953-2600
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    Fax                  |    770-953-2602
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     JOHN C LIPMAN 
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    Credential           |    MD
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    Telephone            |    770-953-2600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    2085R0204X
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    Taxonomy Name        |    Vascular & Interventional Radiology Physician
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    License Number       |    
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    License Number State |    
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