1902114879 NPI number — METROPOLITAN WASHINGTON ORTHOPAEDIC ASSOCIATION

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902114879 NPI number — METROPOLITAN WASHINGTON ORTHOPAEDIC ASSOCIATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
METROPOLITAN WASHINGTON ORTHOPAEDIC ASSOCIATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
PHYSICAL MEDICINE REHAB CENTER
Provider Other Organization Name Type Code:
5
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:
1902114879
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
417 N WASHINGTON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALEXANDRIA
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22314-2311
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-839-3373
Provider Business Mailing Address Fax Number:
301-749-0027

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6144 OXON HILL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OXON HILL
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20745-3107
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-839-3373
Provider Business Practice Location Address Fax Number:
301-749-0027
Provider Enumeration Date:
09/14/2010

Additional Information

Authorized Official

Authorized Official Last Name:
AZER
Authorized Official First Name:
RIDA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT OF THE COMPANY
Authorized Official Telephone Number:
301-839-3373

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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