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General NPI Number Information
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NPI Number | 1679753958
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Entity Type | Organization
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Legal Business Name | ANDREW PANAGOS, MD,P.C.
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Dates
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Enumeration Date | 11/05/2007
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Last Update Date | 07/29/2010
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Provider Practice Location Address
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Address Line | 6410 ROCKLEDGE DR SUITE 210
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City | BETHESDA
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State | MD
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Zip | 20817-1809
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Country | US
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Telephone | 301-493-6331
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Fax | 301-493-8234
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Provider Business Mailing Address
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Address Line | 6410 ROCKLEDGE DR SUITE 210
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City | BETHESDA
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State | MD
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Zip | 20817-1809
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Country | US
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Telephone | 301-493-6331
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Fax | 301-493-8234
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANDREW V PANAGOS
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Credential | M.D.
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Telephone | 301-493-6331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | D29883
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License Number State | MD
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