Provider Demographics
NPI:1376091355
Name:AFFILIATED SPECIALISTS, LLC
Entity Type:Organization
Organization Name:AFFILIATED SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:SIEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-823-8086
Mailing Address - Street 1:9821 GREENBELT RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2265
Mailing Address - Country:US
Mailing Address - Phone:301-823-8086
Mailing Address - Fax:
Practice Address - Street 1:9821 GREENBELT RD
Practice Address - Street 2:SUITE 104
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2265
Practice Address - Country:US
Practice Address - Phone:301-823-8086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-19
Last Update Date:2016-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty