Organization
VASCULAR ACCESS CENTER OF PRINCE GEORGES COUNTY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY J PARKINSON (CEO)
(215) 382-3680
Entity
Organization
Contact information
Practice address
1019 BRIGHTSEAT RD, LANDOVER, MD 20785-3738
(301) 350-6009
Mailing address
1019 BRIGHTSEAT RD, LANDOVER, MD 20785-3738
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
—
—
2083P0901X
Public Health & General Preventive Medicine Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1231186
AETNA
MD
05
—
1518996644
—
VA
01
—
33QDVA
CAREFIRST BCBS
MD
05
—
410431500
—
MD
01
—
DF1638
RRW
MD
Enumeration date
07/01/2006
Last updated
06/27/2013
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