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Organization

CARDIAC CARE ASSOCIATES PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KENNETH M BROOKS MD (MD MANAGING PARTNER)
(703) 641-9161
Entity
Organization

Contact information

Practice address
3023 HAMAKER CT, SUITE #100, FAIRFAX, VA 22031
(703) 641-9161
(703) 641-0383
Mailing address
3023 HAMAKER COURT, SUITE #100, FAIRFAX, VA 22031
(703) 641-9161
(703) 641-0383

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DA1708
RAIL ROAD MEDICARE ID
VA
Enumeration date
08/31/2006
Last updated
12/22/2009
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