1780708669 NPI number — DR. DIDACE KABATSI M.D.

Table of content: DR. DIDACE KABATSI M.D. (NPI 1780708669)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780708669 NPI number — DR. DIDACE KABATSI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KABATSI
Provider First Name:
DIDACE
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1780708669
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
818 18TH ST NW STE 620
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20006-3513
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-822-9600
Provider Business Mailing Address Fax Number:
202-822-8099

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
818 18TH ST NW STE 620
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20006-3513
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-822-9600
Provider Business Practice Location Address Fax Number:
202-822-8099
Provider Enumeration Date:
03/18/2007

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: 174400000X , with the licence number:  MD9107 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: MD9107 . This is a "MEDICAL LICENSE NO" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".