| NPI | 1548406960 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE BURTON Credentialing/Contracts Manager 301-868-8485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X (Licence: MD D24644) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD H0061922) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MD D0059944) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MD D26021) | |
| 363A00000X Physician Assistant (Licence: MD C0003134) | |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: MD R119098) | |
| Enumeration Date | 2009-01-07 |
| Last Update Date | 2025-04-28 |