Provider Demographics
NPI:1356388821
Name:CAPITAL ORTHOPAEDIC SPECIALISTS PA
Entity type:Organization
Organization Name:CAPITAL ORTHOPAEDIC SPECIALISTS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:J MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:JOLY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-599-1000
Mailing Address - Street 1:9135 PISCATAWAY RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-2549
Mailing Address - Country:US
Mailing Address - Phone:301-599-1000
Mailing Address - Fax:301-856-7685
Practice Address - Street 1:9135 PISCATAWAY RD
Practice Address - Street 2:SUITE 300
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-2549
Practice Address - Country:US
Practice Address - Phone:301-599-1000
Practice Address - Fax:301-856-7685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD410079Medicare ID - Type UnspecifiedGROUP NUMBER