Provider Demographics
NPI:1306093844
Name:CAPITOL CARDIOVASCULAR & THORACIC SURGERY ASSOC. PC
Entity type:Organization
Organization Name:CAPITOL CARDIOVASCULAR & THORACIC SURGERY ASSOC. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SALIM
Authorized Official - Middle Name:
Authorized Official - Last Name:AZIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-775-5111
Mailing Address - Street 1:6035 BURKE CENTRE PKWY
Mailing Address - Street 2:#390
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-3750
Mailing Address - Country:US
Mailing Address - Phone:703-978-1196
Mailing Address - Fax:703-978-7762
Practice Address - Street 1:2240 M STREET, NW
Practice Address - Street 2:#505
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1498
Practice Address - Country:US
Practice Address - Phone:202-755-5111
Practice Address - Fax:202-775-5112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-27
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCG01066Medicare PIN