Organization
SPAA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN GRAGNOLATI (PRESIDENT)
(301) 896-2574
Entity
Organization
Contact information
Practice address
8600 OLD GEORGETOWN RD, SUBURBAN HOSPITAL, BETHESDA, MD 20814
(301) 896-3100
Mailing address
PO BOX 79050, SUBURBAN PHYSICIAN ASSISTANT ASSOCIATES, BALTIMORE, MD 21279-0050
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
C0000937
MD
Other
Enumeration date
05/07/2007
Last updated
08/22/2020
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