Provider Demographics
NPI:1093553547
Name:CAPITAL DIGESTIVE CARE, LLC
Entity type:Organization
Organization Name:CAPITAL DIGESTIVE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RODERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:KREISBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-335-2899
Mailing Address - Street 1:10770 COLUMBIA PIKE STE 400
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-4462
Mailing Address - Country:US
Mailing Address - Phone:240-485-5200
Mailing Address - Fax:301-576-8456
Practice Address - Street 1:3415 OLANDWOOD CT STE 101
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1490
Practice Address - Country:US
Practice Address - Phone:301-593-2002
Practice Address - Fax:301-593-4781
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAPITAL DIGESTIVE CARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-07-18
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty