# ERAN KESSOUS MD PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MONTGOMERY SPORTS MEDICINE CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104282409
- **Authorized official:** MS. DONA MARIA BOWIE (OFFICE MANAGER)
- **Authorized official phone:** (301) 754-0505

## Contact information

- **Practice address:** 11120 NEW HAMPSHIRE AVE, 411, SILVER SPRING, MD 20904-2633
- **Practice address phone:** (301) 754-0505
- **Practice address fax:** (301) 754-0509
- **Mailing address:** 11120 NEW HAMPSHIRE AVE, 411, SILVER SPRING, MD 20904-2633
- **Mailing address phone:** (301) 754-0505
- **Mailing address fax:** (301) 754-0509

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | D0066523 | MD | Yes |

## Other

- **Enumeration date:** 01/04/2016
- **Last updated:** 01/04/2016