Provider Demographics
NPI:1457549552
Name:METRO COLON AND RECTAL SURGERY PC
Entity type:Organization
Organization Name:METRO COLON AND RECTAL SURGERY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:HOUCK
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:301-681-6437
Mailing Address - Street 1:4701 RANDOLPH RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-2257
Mailing Address - Country:US
Mailing Address - Phone:301-681-6437
Mailing Address - Fax:301-681-0975
Practice Address - Street 1:4701 RANDOLPH RD
Practice Address - Street 2:SUITE 203
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-2257
Practice Address - Country:US
Practice Address - Phone:301-681-6437
Practice Address - Fax:301-681-0975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-15
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty