| Capital Primary And Geriatric Care, Llc | |
|
100 1st St Suite 130 Rockville MD 20851-1314 | |
| (301) 258-1904 | |
| (301) 339-7722 |
| Full Name | Capital Primary And Geriatric Care, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 100 1st St, Rockville, Maryland |
| Authorized Official Name and Position | Tina Aloysius (MANAGER) |
| Authorized Official Contact | 3012581904 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Capital Primary And Geriatric Care, Llc 100 1st St Suite 130 Rockville MD 20851-1314 Ph: (301) 258-1904 | Capital Primary And Geriatric Care, Llc 100 1st St Suite 130 Rockville MD 20851-1314 Ph: (301) 258-1904 |
| NPI Number | 1689936304 |
|---|---|
| Provider Enumeration Date | 06/08/2012 |
| Last Update Date | 06/08/2012 |
| Medicare PECOS PAC ID | 5597920389 |
|---|---|
| Medicare Enrollment ID | O20120628000533 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689936304 | NPI | - | NPPES |
| 024810000 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD432933 (Maryland) | Primary |
| Provider Name | Summit Gupta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942485321 PECOS PAC ID: 6406931674 Enrollment ID: I20110107000257 |
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