# ATHANASIUS D. GEORGE, M.D., LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ATHANASIUS D. GEORGE, M.D., LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1962681098
- **Legal business name:** ATHANASIUS D. GEORGE, M.D., LLC
- **Authorized official:** ATHANASIUS DEMOSTHENES GEORGE M.D. (OWNER/ SOLE MEMBER)
- **Authorized official phone:** (301) 916-4500

## Contact information

- **Practice address:** 19735 GERMANTOWN RD, SUITE 240, GERMANTOWN, MD 20874-1214
- **Practice address phone:** (301) 916-4500
- **Practice address fax:** (301) 916-6131
- **Mailing address:** 19735 GERMANTOWN RD, SUITE 240, GERMANTOWN, MD 20874-1214
- **Mailing address phone:** (301) 916-4500
- **Mailing address fax:** (301) 916-6131

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | D0056274 | MD | Yes |

## Other

- **Enumeration date:** 10/25/2007
- **Last updated:** 10/25/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0801568 | UNITED HEALTHCARE | MD |
| 01 | — | 483373 | MAMSI MD IPA OPT CHOICE | MD |
| 01 | — | 61704301 | CAREFIRST BCBS | MD |
| 01 | — | F911-0001 | CAREFIRST BCBS | DC |