Provider Demographics
NPI:1407282866
Name:VASCULAR CENTERS OF AMERICA LLC
Entity Type:Organization
Organization Name:VASCULAR CENTERS OF AMERICA 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:703-994-6655
Mailing Address - Street 1:7610 CARROLL AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-6384
Mailing Address - Country:US
Mailing Address - Phone:301-891-2500
Mailing Address - Fax:301-891-1704
Practice Address - Street 1:7610 CARROLL AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-6384
Practice Address - Country:US
Practice Address - Phone:301-891-2500
Practice Address - Fax:301-891-1704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-17
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0042222207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty