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Organization

BETHESDA RETINA,LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SRINIVAS M SASTRY M.D. (OWNER)
(301) 843-9971
Entity
Organization

Contact information

Practice address
10215 FERNWOOD RD, SUITE 305, BETHESDA, MD 20817-1106
(301) 896-0101
Mailing address
P.O. BOX 1375, WALDORF, MD 20604

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1277702
UNITED HEALTHCARE
01
349918
ALLIANCE
05
486910900
MD
Enumeration date
12/15/2009
Last updated
12/15/2009
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