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Organization
CENTURION VASCULAR CARE LLC
Active
Organization
CENTURION VASCULAR CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMANUEL FESSAHAYE MD (MEDICAL DIRECTOR)
(571) 282-8699
Entity
Organization
Contact information
Practice address
4230 FORBES BLVD STE E, LANHAM, MD 20706-4399
(571) 282-8699
Mailing address
1111 WYTHE ST, ALEXANDRIA, VA 22314-1842
(571) 282-8699
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
NULL
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
Other
Enumeration date
05/14/2019
Last updated
12/17/2019
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