Provider Demographics
NPI:1083288781
Name:WASHINGTON CARDIOVASCULAR INSTITUTE LLC
Entity Type:Organization
Organization Name:WASHINGTON CARDIOVASCULAR INSTITUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MUBASHAR
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHOUDRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:013-891-2500
Mailing Address - Street 1:7610 CARROLL AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-6311
Mailing Address - Country:US
Mailing Address - Phone:301-918-2500
Mailing Address - Fax:301-448-1679
Practice Address - Street 1:351 W CAMDEN ST STE 201
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-7912
Practice Address - Country:US
Practice Address - Phone:410-541-7800
Practice Address - Fax:410-541-7900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-17
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD408859000Medicaid