Capital Center For Functional Medicine Llc

LBN: Capital Center For Functional Medicine Llc
Capital Center For Functional Medicine Llc is an health care organization with primary practice located at 4701 Sangamore Rd Ste N270 , Bethesda MD 20816-2528. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty. Capital Center For Functional Medicine Llc can be contacted via phone (240) 507-5110, or through Wong, Andrew via phone (301) 892-2658.

Contact Information

Primary practice address
4701 Sangamore Rd Ste N270 Bethesda MD 20816-2528
Phone: (240) 507-5110
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Wong, Andrew Doctor of Medicine (MD)
Phone: (301) 892-2658

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X D66066 Maryland

Profile Details

NPI number 1922496462
LBN Legal business name Capital Center For Functional Medicine Llc
DBA Doing business as
Authorized official Wong, Andrew Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 7th, 2015
Last updated Dec 6th, 2024 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922496462 NPPES
Maryland MEDICAID 014051100

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