Organization
ELITE NUCLEAR CARDIO DIAGNOSTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VICTORIA ENYOGAI ADMINISTRATION (CREDENTIALING MANAGER)
(301) 483-7999
Entity
Organization
Contact information
Practice address
3207 BARCROFT DR, UPPER MARLBORO, MD 20774-2581
(240) 899-5315
(301) 483-7099
Mailing address
3207 BARCOFT DRIVE, UPPER MARLBORO, MD 20774
(240) 899-5315
(301) 483-7099
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
D0026012
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
502474
—
MD
Enumeration date
02/01/2012
Last updated
05/28/2013
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