Provider Demographics
NPI:1861956930
Name:CAPITAL STROKE NEUROLOGY INC
Entity type:Organization
Organization Name:CAPITAL STROKE NEUROLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:H
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-607-2705
Mailing Address - Street 1:9117 FALLS CHAPEL WAY
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-2453
Mailing Address - Country:US
Mailing Address - Phone:434-607-2705
Mailing Address - Fax:443-964-5954
Practice Address - Street 1:9117 FALLS CHAPEL WAY
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-2453
Practice Address - Country:US
Practice Address - Phone:434-607-2705
Practice Address - Fax:443-964-5954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-23
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty