Organization
POTOMAC GROVE PSYCHIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOUIS E KOPOLOW MD (OWNER)
(301) 963-0060
Entity
Organization
Contact information
Practice address
8915 SHADY GROVE CT, GAITHERSBURG, MD 20877-1308
(301) 963-0060
(301) 258-7482
Mailing address
8915 SHADY GROVE CT, GAITHERSBURG, MD 20877-1308
(301) 963-0060
(301) 258-7482
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
D0016788
MD
Other
Enumeration date
05/10/2007
Last updated
07/08/2010
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