Organization
ERAN KESSOUS MD PC
Active
Other names
MONTGOMERY SPORTS MEDICINE CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DONA MARIA BOWIE (OFFICE MANAGER)
(301) 754-0505
Entity
Organization
Contact information
Practice address
11120 NEW HAMPSHIRE AVE, 411, SILVER SPRING, MD 20904-2633
(301) 754-0505
(301) 754-0509
Mailing address
11120 NEW HAMPSHIRE AVE, 411, SILVER SPRING, MD 20904-2633
(301) 754-0505
(301) 754-0509
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
D0066523
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
182336
MEDICARE PTAN
MD
Enumeration date
01/04/2016
Last updated
01/04/2016
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