| Organization Name: | MINIMALLY INVASIVE VASCULAR CENTER |
| NPI Number: | 1457592685 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WENDY L MUHAMMAD (DIRECTOR OF BUSINESS AFFAIRS) |
| Mailing Address: | 8730 Cherry Lane Suite 10 Laurel |
| State: | MD US |
| Postal Code: | 20707 |
| Phone Number: | 3014971590 |
| Fax Number: | 2403344781 |
| NPI Enumeration Date: | 03/18/2009 |
| NPI Last Update Date: | 04/24/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | H0065639 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MD |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |