| Elite Nuclear Cardio Diagnostics | |
|
3207 Barcroft Dr Upper Marlboro MD 20774-2581 | |
| (240) 899-5315 | |
| (301) 483-7099 |
| Full Name | Elite Nuclear Cardio Diagnostics |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 3207 Barcroft Dr, Upper Marlboro, Maryland |
| Authorized Official Name and Position | Victoria Enyogai (CREDENTIALING MANAGER) |
| Authorized Official Contact | 3014837999 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Nuclear Cardio Diagnostics 3207 Barcoft Drive Upper Marlboro MD 20774 Ph: (240) 899-5315 | Elite Nuclear Cardio Diagnostics 3207 Barcroft Dr Upper Marlboro MD 20774-2581 Ph: (240) 899-5315 |
| NPI Number | 1639441017 |
|---|---|
| Provider Enumeration Date | 02/01/2012 |
| Last Update Date | 05/28/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639441017 | NPI | - | NPPES |
| 502474 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | D0026012 (Maryland) | Primary |
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