Basic Information
| Provider Information | |||||||||
| NPI: | 1619037207 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CAPITAL GASTROENTEROLOGY CONSULTANTS PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1476 | ||||||||
| Address2: | |||||||||
| City: | HAGERSTOWN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 217411476 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3015932002 | ||||||||
| FaxNumber: | 3015931170 | ||||||||
| Practice Location | |||||||||
| Address1: | 10801 LOCKWOOD DR | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | SILVER SPRING | ||||||||
| State: | MD | ||||||||
| PostalCode: | 209011556 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3015932002 | ||||||||
| FaxNumber: | 3015931170 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/12/2006 | ||||||||
| LastUpdateDate: | 10/18/2007 | ||||||||
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| AuthorizedOfficialLastName: | LEVY | ||||||||
| AuthorizedOfficialFirstName: | ARNOLD | ||||||||
| AuthorizedOfficialMiddleName: | G | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3015932002 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.