1730342759 NPI number — COLLEEN MCGETTIGAN DO

Table of content: COLLEEN MCGETTIGAN DO (NPI 1730342759)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730342759 NPI number — COLLEEN MCGETTIGAN DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCGETTIGAN
Provider First Name:
COLLEEN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
POWERS
Provider Other First Name:
COLLEEN
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DO
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1730342759
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
25714 RIDGE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DAMASCUS
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20872-1852
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
240-731-8330
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
NATIONAL NAVAL MEDICAL CTR
Provider Second Line Business Practice Location Address:
8901 WISCONSIN AVENUE
Provider Business Practice Location Address City Name:
BETHESDA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20889-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-435-5387
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/09/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RX0202X , with the licence number:  9900650 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)