Organization
ADVANCE VASCULAR LABS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRADEEP SRIVASTAVA MD (CEO)
(301) 312-1291
Entity
Organization
Contact information
Practice address
7227 HANOVER PKWY STE B, GREENBELT, MD 20770-2025
(301) 474-9222
(301) 374-9225
Mailing address
7227 HANOVER PKWY STE B, GREENBELT, MD 20770-2025
(301) 474-9222
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
—
—
Other
Enumeration date
09/29/2022
Last updated
09/29/2022
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