Provider Demographics
NPI:1104319698
Name:CAPITAL CRITICAL CARE & INFORMATICS PC
Entity type:Organization
Organization Name:CAPITAL CRITICAL CARE & INFORMATICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MADHUSUDANAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMASWAMY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:571-308-6768
Mailing Address - Street 1:2776 S ARLINGTON MILL DR # 103
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-3402
Mailing Address - Country:US
Mailing Address - Phone:571-308-6768
Mailing Address - Fax:571-285-0027
Practice Address - Street 1:4320 SEMINARY RD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-1535
Practice Address - Country:US
Practice Address - Phone:703-504-3000
Practice Address - Fax:571-285-0027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-11
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1013165455Medicaid