Provider Demographics
NPI:1235293937
Name:CARDIOCARE LLC
Entity Type:Organization
Organization Name:CARDIOCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:FLYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-656-5050
Mailing Address - Street 1:5530 WISCONSIN AVE STE 700
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-4401
Mailing Address - Country:US
Mailing Address - Phone:301-656-5050
Mailing Address - Fax:301-654-4237
Practice Address - Street 1:5530 WISCONSIN AVE
Practice Address - Street 2:SUITE 700
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-4404
Practice Address - Country:US
Practice Address - Phone:301-656-5050
Practice Address - Fax:301-654-4237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD093382S12Medicare PIN