Organization Name: | CAPITAL COORDINATED MEDICINE, LLC |
NPI Number: | 1689069007 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | AMY LISE SCHIFFMAN (PRESIDENT, MEDICAL DIRECTOR) |
Mailing Address: | 10335 Kensington Pkwy Suite G Kensington |
State: | MD US |
Postal Code: | 208953359 |
Phone Number: | 2407440001 |
Fax Number: | 8882060912 |
NPI Enumeration Date: | 04/02/2015 |
NPI Last Update Date: | 04/02/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |