Provider Demographics
NPI:1902440076
Name:SUBURBAN MARYLAND UROLOGY ASSOCIATES LLC
Entity Type:Organization
Organization Name:SUBURBAN MARYLAND UROLOGY ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ROY
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-943-5082
Mailing Address - Street 1:PO BOX 34045
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20827-0045
Mailing Address - Country:US
Mailing Address - Phone:301-670-4250
Mailing Address - Fax:
Practice Address - Street 1:6001 MONTROSE RD STE 1040
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4874
Practice Address - Country:US
Practice Address - Phone:301-670-4250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-01
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty