| Potomac Grove Psychiatry | |
|
8915 Shady Grove Ct Gaithersburg MD 20877-1308 | |
| (301) 963-0060 | |
| (301) 258-7482 |
| Full Name | Potomac Grove Psychiatry |
|---|---|
| Speciality | Psychologist |
| Location | 8915 Shady Grove Ct, Gaithersburg, Maryland |
| Authorized Official Name and Position | Louis E Kopolow (OWNER) |
| Authorized Official Contact | 3019630060 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Potomac Grove Psychiatry 8915 Shady Grove Ct Gaithersburg MD 20877-1308 Ph: (301) 963-0060 | Potomac Grove Psychiatry 8915 Shady Grove Ct Gaithersburg MD 20877-1308 Ph: (301) 963-0060 |
| NPI Number | 1912111667 |
|---|---|
| Provider Enumeration Date | 05/10/2007 |
| Last Update Date | 07/08/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912111667 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | D0016788 (Maryland) | Primary |
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