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Organization

CAPITAL NEURO CARE PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RATNAVALI KOLLA M.D. (PRESIDENT / SOLE PROPRIETOR)
(301) 869-2358
Entity
Organization

Contact information

Practice address
16003 COMPRINT CIR STE 209, GAITHERSBURG, MD 20877-1318
(301) 869-2358
(301) 869-2360
Mailing address
10301 GEORGIA AVE, SUITE 209, SILVER SPRING, MD 20902-5020
(301) 593-9800
(301) 593-1061

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
039326600
DC
05
413840600
MD
Enumeration date
12/21/2007
Last updated
06/20/2019
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