Provider Demographics
NPI:1104353374
Name:CANCER AND BLOOD DISORDERS TREATMENT CENTER LLC
Entity type:Organization
Organization Name:CANCER AND BLOOD DISORDERS TREATMENT CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:M. ASHRAF
Authorized Official - Middle Name:
Authorized Official - Last Name:MEELU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-638-1007
Mailing Address - Street 1:3261 OLD WASHINGTON RD STE 1030
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-3310
Mailing Address - Country:US
Mailing Address - Phone:301-638-1007
Mailing Address - Fax:301-638-1009
Practice Address - Street 1:3261 OLD WASHINGTON RD STE 1030
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-3310
Practice Address - Country:US
Practice Address - Phone:301-638-1007
Practice Address - Fax:301-638-1009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-17
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0046246207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Single Specialty