Provider Demographics
NPI:1093091399
Name:VASCULAR INTERVENTIONS LLC
Entity Type:Organization
Organization Name:VASCULAR INTERVENTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:ALFORD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-807-4055
Mailing Address - Street 1:8201 16TH ST
Mailing Address - Street 2:#309
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3240
Mailing Address - Country:US
Mailing Address - Phone:301-807-4055
Mailing Address - Fax:301-560-5257
Practice Address - Street 1:8201 16TH ST
Practice Address - Street 2:#309
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3240
Practice Address - Country:US
Practice Address - Phone:301-807-4055
Practice Address - Fax:301-560-5257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00429312086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD097700400Medicaid