Provider Demographics
NPI:1184627473
Name:CARDIOLOGY CENTER LLP
Entity type:Organization
Organization Name:CARDIOLOGY CENTER LLP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:KUSAY
Authorized Official - Middle Name:
Authorized Official - Last Name:BARAKAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-694-5900
Mailing Address - Street 1:310 W NINTH ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-4546
Mailing Address - Country:US
Mailing Address - Phone:301-694-5900
Mailing Address - Fax:301-694-0569
Practice Address - Street 1:310 W NINTH ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4546
Practice Address - Country:US
Practice Address - Phone:301-694-5900
Practice Address - Fax:301-694-0569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD21648207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD158LMedicare ID - Type Unspecified