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NPI Code Detail

MEDICARE: WASHINGTON VASCULAR SURGI CENTER LLC

MEDICARE: WASHINGTON VASCULAR SURGI CENTER LLC
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
1208600000XSurgery Physician
2261QM1300XMulti-Specialty Clinic/Center

General Provider Information

NPI Number : 1821526021
Entity Type Code : Organization
Provider Name (Legal Business Name) : WASHINGTON VASCULAR SURGI CENTER LLC
Provider Business Mailing Address
First Line : 15245 SHADY GROVE RD STE 325N
Second Line :
City : ROCKVILLE
State : MD
Zip : 20850-3222
Country : US
Telephone Number : 301-891-2500
Fax Number : 301-448-1679
Provider Business Practice Location Address
First Line : 7610 CARROLL AVE STE 100
Second Line :
City : TAKOMA PARK
State : MD
Zip : 20912-6311
Country : US
Telephone Number : 301-891-2500
Fax Number : 301-891-2500
Authorized Official
Title or Position : OWNER
Name : MUBASHAR A. CHOUDRY
Credential : MD
Telephone Number : 301-891-2500
Provider Enumeration Date : 06/01/2017
Last Update Date : 07/05/2017

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Directions to “WASHINGTON VASCULAR SURGI CENTER LLC ” Practice Location

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