Organization
EDWARD N. BODURIAN, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANGELA D JONES (OFFICE MANAGER)
(301) 656-4064
Entity
Organization
Contact information
Practice address
5530 WISCONSIN AVE, SUITE 515, CHEVY CHASE, MD 20815-4404
(301) 656-4064
(301) 657-9561
Mailing address
5530 WISCONSIN AVE, SUITE 515, CHEVY CHASE, MD 20815-4404
(301) 656-4064
(301) 657-9561
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32331400
—
MD
05
—
445870
—
DC
01
—
A575
CAREFIRST BLUE CROSS BLUE SHIELD
MD
01
—
CD9109
RAILROAD MEDICARE
MD
Enumeration date
04/06/2007
Last updated
07/17/2008
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