Provider Demographics
NPI:1255899621
Name:ADVANCED CARDIOVASCULAR INSTITUTE
Entity type:Organization
Organization Name:ADVANCED CARDIOVASCULAR INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:
Authorized Official - Last Name:OPOKU-ASARE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-755-6500
Mailing Address - Street 1:12120 PLUM ORCHARD DR STE 150
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-7820
Mailing Address - Country:US
Mailing Address - Phone:301-755-6500
Mailing Address - Fax:240-345-9227
Practice Address - Street 1:12120 PLUM ORCHARD DR STE 150
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-7820
Practice Address - Country:US
Practice Address - Phone:301-755-6500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-05
Last Update Date:2022-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty