Provider Demographics
NPI:1598737751
Name:THE NEUROLOGY CENTER
Entity Type:Organization
Organization Name:THE NEUROLOGY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN FOSSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-562-7200
Mailing Address - Street 1:8555 16TH ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-2816
Mailing Address - Country:US
Mailing Address - Phone:301-562-7200
Mailing Address - Fax:301-565-6771
Practice Address - Street 1:8555 16TH ST
Practice Address - Street 2:SUITE 310
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-2816
Practice Address - Country:US
Practice Address - Phone:301-562-7200
Practice Address - Fax:301-565-6771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-02
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD178188Medicare PIN