Provider Demographics
NPI:1477632230
Name:METROPOLITAN CARDIOVASCULAR
Entity Type:Organization
Organization Name:METROPOLITAN CARDIOVASCULAR
Other - Org Name:METROPOLITAN MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:AYIM
Authorized Official - Middle Name:KWASI
Authorized Official - Last Name:AKYEA DJAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD FACC
Authorized Official - Phone:301-595-0356
Mailing Address - Street 1:PO BOX 1234
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20725-1234
Mailing Address - Country:US
Mailing Address - Phone:301-595-0356
Mailing Address - Fax:301-595-1069
Practice Address - Street 1:10756 RHODE ISLAND AVE
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-2513
Practice Address - Country:US
Practice Address - Phone:301-595-0356
Practice Address - Fax:301-595-1069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0050898174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD134402100Medicaid
MDG01328Medicare ID - Type Unspecified
H23696Medicare UPIN