Provider Demographics
NPI:1679618656
Name:CAPITOL PSYCHIATRIC GROUP
Entity Type:Organization
Organization Name:CAPITOL PSYCHIATRIC GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIOT
Authorized Official - Middle Name:
Authorized Official - Last Name:SOREL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-293-2112
Mailing Address - Street 1:7361 CALHOUN PL
Mailing Address - Street 2:SUITE 220
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20855-2765
Mailing Address - Country:US
Mailing Address - Phone:301-565-2250
Mailing Address - Fax:
Practice Address - Street 1:2301 E ST NW APT A1011
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-2839
Practice Address - Country:US
Practice Address - Phone:202-293-2112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC102412084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCG00450Medicare PIN