Provider Demographics
NPI:1619088341
Name:CAPITOL MEDICAL GROUP
Entity type:Organization
Organization Name:CAPITOL MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-907-3690
Mailing Address - Street 1:8401 CONNECTICUT AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-5803
Mailing Address - Country:US
Mailing Address - Phone:301-907-3960
Mailing Address - Fax:
Practice Address - Street 1:8401 CONNECTICUT AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-5803
Practice Address - Country:US
Practice Address - Phone:301-907-3960
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD202032080A0000X
MDD20303261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty
Not Answered261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care