Organization
MARYLAND AND VIRGINIA PHLEBOLOGY PC
Active
Other names
Vein Clinics of America
Organization subpart
No
Provider details
NPI number
Authorized official
NATHAN AMORUSO (SR VP REVENUE)
(224) 318-0118
Entity
Organization
Contact information
Practice address
1500 WHETSTONE WAY STE 104, BALTIMORE, MD 21230-4772
(410) 244-8110
Mailing address
PO BOX 971, NORTHBROOK, IL 60065-0971
(847) 593-8460
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
208600000X
Surgery Physician
Primary
—
—
2086S0129X
Vascular Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DG0518
MEDICARE RAILROAD
VA
Enumeration date
10/17/2006
Last updated
03/25/2025
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