Provider Demographics
NPI:1588606115
Name:WASHINGTON CARDIOTHORACIC SURGERY ASSOC.,PLLC
Entity Type:Organization
Organization Name:WASHINGTON CARDIOTHORACIC SURGERY ASSOC.,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:FARID
Authorized Official - Middle Name:
Authorized Official - Last Name:GHARAGOZLOO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-601-9600
Mailing Address - Street 1:PO BOX 60
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20875-0060
Mailing Address - Country:US
Mailing Address - Phone:301-601-9600
Mailing Address - Fax:301-601-3771
Practice Address - Street 1:2175 K ST NW
Practice Address - Street 2:SUITE 300
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1831
Practice Address - Country:US
Practice Address - Phone:202-775-9375
Practice Address - Fax:202-775-1599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD484AWAOtherCARE FIRST BLUE SHIELD
DCJ449OtherCAREFIRST BLUESHIELD
MD838MMedicare PIN
DCG01458Medicare ID - Type UnspecifiedGROUP MEDICARE#