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NPI Code Detail

MEDICARE: ICU PHYSICIANS, PC

MEDICARE: ICU PHYSICIANS, PC
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
1207RC0200XCritical Care Medicine (Internal Medicine) PhysicianD0026262MD

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2DA4019OTHERRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
37821OTHERDCCAREFIRST OF DC

General Provider Information

NPI Number : 1669477386
Entity Type Code : Organization
Provider Name (Legal Business Name) : ICU PHYSICIANS, PC
Provider Business Mailing Address
First Line : PO BOX 441325
Second Line :
City : FORT WASHINGTON
State : MD
Zip : 20749-1325
Country : US
Telephone Number : 301-983-6656
Fax Number : 301-983-8110
Provider Business Practice Location Address
First Line : 11711 LIVINGSTON RD
Second Line :
City : FORT WASHINGTON
State : MD
Zip : 20744-5151
Country : US
Telephone Number : 301-203-2232
Fax Number : 301-203-2054
Authorized Official
Title or Position : PRESIDENT
Name : DR. SAMUEL KLEIMAN
Credential :
Telephone Number : 301-203-2232
Provider Enumeration Date : 06/17/2005
Last Update Date : 02/23/2010

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