Provider Demographics
NPI:1073341160
Name:CAPITAL DIABETES & ENDOCRINE ASSOCIATES LLC
Entity type:Organization
Organization Name:CAPITAL DIABETES & ENDOCRINE ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROMEU
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:AZEVEDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-899-7713
Mailing Address - Street 1:5801 ALLENTOWN RD STE 500
Mailing Address - Street 2:
Mailing Address - City:CAMP SPRINGS
Mailing Address - State:MD
Mailing Address - Zip Code:20746-4518
Mailing Address - Country:US
Mailing Address - Phone:301-899-7713
Mailing Address - Fax:
Practice Address - Street 1:3995 OLD TOWN RD STE 202
Practice Address - Street 2:
Practice Address - City:HUNTINGTOWN
Practice Address - State:MD
Practice Address - Zip Code:20639-3041
Practice Address - Country:US
Practice Address - Phone:301-899-7713
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAPITAL DIABETES & ENDOCRINE ASSOCIATES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty