Provider Demographics
NPI:1811107543
Name:MARYLAND CARDIAC & MEDICAL ASSOCIATES, PC.
Entity type:Organization
Organization Name:MARYLAND CARDIAC & MEDICAL ASSOCIATES, PC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-474-9222
Mailing Address - Street 1:P.O. BOX 59702
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20859
Mailing Address - Country:US
Mailing Address - Phone:301-474-9222
Mailing Address - Fax:301-474-9225
Practice Address - Street 1:7227-B HANOVER PARKWAY
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770
Practice Address - Country:US
Practice Address - Phone:301-474-9222
Practice Address - Fax:301-474-9225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0055109207R00000X
MDD0052815207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
003815P50Medicare ID - Type Unspecified
003815P50Medicare ID - Type Unspecified