Organization · NPI-2

Advance Vascular Labs

Clinic/Center · Greenbelt, MD

NPI number1558085845
StatusActive
Last updated in NPPESSep 29, 2022

Details

NPI
1558085845
Entity type
Organization (NPI-2)
Legal business name
Advance Vascular Labs
Organization subpart
No
Enumeration date
Sep 29, 2022
Certification date
Sep 29, 2022
Last updated
Sep 29, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center––Yes
207R00000X Internal Medicine––
261QA1903X Clinic/Center, Ambulatory Surgical––

Practice location

7227 Hanover Pkwy Ste B
Greenbelt, MD 20770-2025

Phone 301-474-9222 · Fax 301-374-9225

Mailing address

7227 Hanover Pkwy Ste B
Greenbelt, MD 20770-2025

Phone 301-474-9222

Authorized official

Pradeep Srivastava
Ceo
3013121291

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