Capital Dermatology LTD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

CAPITAL DERMATOLOGY LTD

Practice address

4660 Kenmore Ave Ste 500
Alexandria, VA 22304-1300

Phone

(703) 370-0073

Fax

(703) 370-2002

NPI assigned

Oct 9, 2006

Last updated

Apr 1, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bruce David Glassman, M.D.NPI 1730151119

Title

President

Phone

(703) 370-0073

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bruce David Glassman, M.D.

  • Dermatology Physician
  • Alexandria, VA
  • NPI 1730151119
  Authorized official Same address or phone

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301616000000",
    "number": "1295822419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4660 KENMORE AVE STE 500",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223041300",
            "telephone_number": "703-370-0073",
            "fax_number": "703-370-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 KENMORE AVE STE 500",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223041300",
            "telephone_number": "703-370-0073",
            "fax_number": "703-370-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL DERMATOLOGY LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2011-04-01",
        "status": "A",
        "authorized_official_last_name": "GLASSMAN",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-370-0073",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO GROUP",
            "identifier": "0483568",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER GROUP",
            "identifier": "111874",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO GROUP",
            "identifier": "5629309",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Dermatology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2011; 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.