MEDICARE: JAMES LAREDO MD

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	2086S0129X	Vascular Surgery Physician	0101236718	VA
2	2086S0129X	Vascular Surgery Physician	34988	DC

General Provider Information

NPI Number	:	1750380911
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES LAREDO MD

Provider Business Mailing Address
First Line	:	7474 GREENWAY CENTER DR STE 900
Second Line	:
City	:	GREENBELT
State	:	MD
Zip	:	20770-3504
Country	:	US
Telephone Number	:	301-982-2000
Fax Number	:	301-982-2001

Provider Business Practice Location Address
First Line	:	8316 ARLINGTON BLVD STE 515
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22031-5216
Country	:	US
Telephone Number	:	301-982-2000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	11/20/2024

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Directions to “ JAMES LAREDO MD” Practice Location

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