Organization
MINIMALLY INVASIVE VASCULAR CENTER OF MARYLAND LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY L MUHAMMAD (PRESIDENT)
(301) 497-1590
Entity
Organization
Contact information
Practice address
8730 CHERRY LANE, SUITE 10, LAUREL, MD 20707
(301) 497-1590
(240) 334-4781
Mailing address
8730 CHERRY LN STE 10, LAUREL, MD 20707-6212
(301) 497-1590
(240) 334-4781
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
H0065639
MD
2086S0129X
Vascular Surgery Physician
D0034245
DC
2086S0129X
Vascular Surgery Physician
Primary
H0065639
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
031107300
—
MD
05
—
054737700
—
DC
Enumeration date
03/18/2009
Last updated
02/08/2021
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