# HEART CENTER OF SOUTHERN MARYLAND

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568917383
- **Authorized official:** GOPALAKRISHNAN SRINIVASAN M.D (CEO)
- **Authorized official phone:** (301) 645-4793

## Contact information

- **Practice address:** 3510 OLD WASHINGTON RD, SUITE 100, WALDORF, MD 20602-3233
- **Practice address phone:** (301) 645-4793
- **Mailing address:** 3510 OLD WASHINGTON RD, SUITE 100, WALDORF, MD 20602-3233

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | — | MD | Yes |

## Other

- **Enumeration date:** 08/22/2016
- **Last updated:** 08/22/2016