Provider Demographics
NPI:1497380968
Name:EMBRIEL LLC
Entity Type:Organization
Organization Name:EMBRIEL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGICAL FIRST ASSIST
Authorized Official - Prefix:
Authorized Official - First Name:GEM
Authorized Official - Middle Name:Y
Authorized Official - Last Name:WALKER LAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:CFA
Authorized Official - Phone:240-320-6521
Mailing Address - Street 1:7512 OYSTER BAY WAY
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20886-5907
Mailing Address - Country:US
Mailing Address - Phone:240-320-6521
Mailing Address - Fax:
Practice Address - Street 1:6500 ROCK SPRING DR STE 100
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1182
Practice Address - Country:US
Practice Address - Phone:240-320-6521
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-05
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty