MEDICARE: PATUXENT CARDIOLOGY ASSOCIATES 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
1	207UN0901X	Nuclear Cardiology Physician
2	207RC0000X	Cardiovascular Disease Physician

General Provider Information

NPI Number	:	1881701175
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATUXENT CARDIOLOGY ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	2419 SOLOMONS ISLAND RD
Second Line	:
City	:	HUNTINGTOWN
State	:	MD
Zip	:	20639-8732
Country	:	US
Telephone Number	:	410-535-3612
Fax Number	:	410-535-3613

Provider Business Practice Location Address
First Line	:	2419 SOLOMONS ISLAND RD
Second Line	:
City	:	HUNTINGTOWN
State	:	MD
Zip	:	20639-8732
Country	:	US
Telephone Number	:	410-535-3612
Fax Number	:	410-535-3613

Authorized Official
Title or Position	:	OWNER
Name	:	DR. VARKEY MATHEW
Credential	:	M.D.
Telephone Number	:	410-535-3612

Provider Enumeration Date	:	08/24/2006
Last Update Date	:	09/25/2008

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