Provider Demographics
NPI:1962593335
Name:ROGAN & O'BRIEN CARDIOVASCULAR ASSOCIATES, P.C.
Entity type:Organization
Organization Name:ROGAN & O'BRIEN CARDIOVASCULAR ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:P
Authorized Official - Last Name:POLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-698-6255
Mailing Address - Street 1:3299 WOODBURN RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-1275
Mailing Address - Country:US
Mailing Address - Phone:703-698-6255
Mailing Address - Fax:703-207-8561
Practice Address - Street 1:3299 WOODBURN RD
Practice Address - Street 2:SUITE 200
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-1275
Practice Address - Country:US
Practice Address - Phone:703-698-6255
Practice Address - Fax:703-207-8561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCG00142Medicare PIN
G00142Medicare PIN