Provider Demographics
NPI:1598190993
Name:ROCKVILLE CARDIOLOGY CENTER PC
Entity Type:Organization
Organization Name:ROCKVILLE CARDIOLOGY CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ABDUL
Authorized Official - Middle Name:H
Authorized Official - Last Name:ABBASI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-768-0552
Mailing Address - Street 1:11103 WELLAND ST
Mailing Address - Street 2:
Mailing Address - City:NORTH POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20878-4862
Mailing Address - Country:US
Mailing Address - Phone:301-768-0552
Mailing Address - Fax:301-933-7002
Practice Address - Street 1:12001 FERRARA AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-4706
Practice Address - Country:US
Practice Address - Phone:301-768-0552
Practice Address - Fax:301-933-7002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-05
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0044155207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD409046200Medicaid