Provider Demographics
NPI:1184853996
Name:METROPOLITAN MEDICAL SPECIALISTS LLC
Entity Type:Organization
Organization Name:METROPOLITAN MEDICAL SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:P
Authorized Official - Last Name:SCANLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-552-8028
Mailing Address - Street 1:8118 GOOD LUCK ROAD
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-0000
Mailing Address - Country:US
Mailing Address - Phone:301-552-8028
Mailing Address - Fax:301-552-8049
Practice Address - Street 1:8116 GOOD LUCK ROAD
Practice Address - Street 2:SUITE 300
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3574
Practice Address - Country:US
Practice Address - Phone:301-441-4801
Practice Address - Fax:301-441-9064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-14
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDW13089602207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty