Provider Demographics
NPI:1780914275
Name:ADVANCE MEDICINE & CARDIOLOGY LLC
Entity type:Organization
Organization Name:ADVANCE MEDICINE & CARDIOLOGY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BALNATH
Authorized Official - Middle Name:
Authorized Official - Last Name:BHANDARY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-330-2700
Mailing Address - Street 1:18550 OFFICE PARK DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY VILLAGE
Mailing Address - State:MD
Mailing Address - Zip Code:20886-0586
Mailing Address - Country:US
Mailing Address - Phone:301-330-2700
Mailing Address - Fax:301-990-7170
Practice Address - Street 1:18550 OFFICE PARK DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY VILLAGE
Practice Address - State:MD
Practice Address - Zip Code:20886-0586
Practice Address - Country:US
Practice Address - Phone:301-330-2700
Practice Address - Fax:301-990-7170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-05
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD33483173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDH00555Medicare UPIN