Shady Grove Family Health Care Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

D16065 Issued in MD

Legal business name

SHADY GROVE FAMILY HEALTH CARE INC

Practice address

14800 Physicians LN
#131
Rockville, MD 20850

Phone

(301) 251-9800

Fax

(301) 251-9802

NPI assigned

Oct 23, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Socrates Fotiu, MD

Title

President

Phone

(301) 251-9800

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211328000000",
    "number": "1255414389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14800 PHYSICIANS LN",
            "address_2": "#131",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "20850",
            "telephone_number": "301-251-9800",
            "fax_number": "301-251-9802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14800 PHYSICIANS LN",
            "address_2": "#131",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "20850",
            "telephone_number": "301-251-9800",
            "fax_number": "301-251-9802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADY GROVE FAMILY HEALTH CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2008-05-21",
        "status": "A",
        "authorized_official_last_name": "FOTIU",
        "authorized_official_first_name": "SOCRATES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-251-9800",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D16065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shady Grove Children'S Gad, LLC
• Shady Grove Children'S Surgery Center, LLC
• Shady Grove Dental Center, LLC
• Shady Grove Dermatology
• Shady Grove Eye & Vision Care, LLC
• Shady Grove Fertility Reproductive Science Center
• Shady Grove Hyperbaric Medicine
• Shady Grove Orthopaedic Assoc, PA
• Shady Grove Pediatric Associates
• Shady Grove Reproductive Science Center PC

• Family Medicine Physician in Rockville, MD
• Providers in Rockville, MD by specialty
• Family Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.