East Coast Gastroenterology LLC

NPI #1992998975 in Largo, Maryland

Provider Information

NPI Number: 1992998975
Entity Type: Organization
Organization Name: East Coast Gastroenterology LLC
Primary Specialty: Internal Medicine - Gastroenterology
Enumeration Date: Aug 22, 2007
Last Updated: Dec 5, 2008

Practice Location

Address: 1450 MERCANTILE LN
Address 2: SUITE 217
City: Largo
State: Maryland
ZIP Code: 20774-5376
Phone: (301) 583-7770

Authorized Official

Name: MICHAEL ROBERT NICHOLS
Title: CREDENTIALING REPRESENTATIVE
Phone: (410) 258-6333

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pathology - Clinical Pathology — Clinical Pathology	207ZC0006X
Internal Medicine - Gastroenterology — Gastroenterology	207RG0100X	Primary

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