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General NPI Number Information
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NPI Number | 1891086203
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Entity Type | Organization
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Legal Business Name | CVM-PRINCE FREDERICK, LLC
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Dates
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Enumeration Date | 04/20/2011
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Last Update Date | 09/13/2011
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Provider Practice Location Address
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Address Line | 301 STEEPLE CHASE DR SUITE 203
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City | PRINCE FREDERICK
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State | MD
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Zip | 20678-4049
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Country | US
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Telephone | 410-535-9282
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Fax |
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Provider Business Mailing Address
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Address Line | 12200 ANNAPOLIS RD SUITE 225
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City | GLENN DALE
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State | MD
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Zip | 20769-9182
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Country | US
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Telephone | 301-860-0003
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF BILLING
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Name | MS. ARUNA THAPAR
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Credential |
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Telephone | 301-860-0003
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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 |
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License Number State |
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