MEDICARE: THE NEUROLOGY CLINIC, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	D25517	MD

General Provider Information

NPI Number	:	1235231325
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE NEUROLOGY CLINIC, P.C.

Provider Business Mailing Address
First Line	:	11350 PEMBROOKE SQ
Second Line	:	SUITE 312
City	:	WALDORF
State	:	MD
Zip	:	20603-4809
Country	:	US
Telephone Number	:	301-843-0803
Fax Number	:

Provider Business Practice Location Address
First Line	:	11350 PEMBROOKE SQ
Second Line	:	SUITE 312
City	:	WALDORF
State	:	MD
Zip	:	20603-4809
Country	:	US
Telephone Number	:	301-843-0803
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. BALJEET S SETHI
Credential	:	M.D.
Telephone Number	:	301-843-0803

Provider Enumeration Date	:	09/01/2006
Last Update Date	:	07/02/2010

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