Provider Demographics
NPI:1982982971
Name:MARYLAND INTERVENTIONAL LLC
Entity Type:Organization
Organization Name:MARYLAND INTERVENTIONAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:RAJENDRA
Authorized Official - Middle Name:RAVINDRA
Authorized Official - Last Name:SHETTY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-908-1433
Mailing Address - Street 1:7219 HANOVER PKWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2021
Mailing Address - Country:US
Mailing Address - Phone:301-908-1433
Mailing Address - Fax:
Practice Address - Street 1:7219 HANOVER PKWY
Practice Address - Street 2:SUITE B
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-2021
Practice Address - Country:US
Practice Address - Phone:301-908-1433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-26
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty