1952388134 NPI number — WASHINGTON ORTHOPAEDIC CENTER

Table of content: (NPI 1952388134)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952388134 NPI number — WASHINGTON ORTHOPAEDIC CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WASHINGTON ORTHOPAEDIC CENTER
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:
ORTHOPAEDIC SUBSPECIALTY REHABILITATION
Provider Other Organization Name Type Code:
3
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:
1952388134
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/13/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 789
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OXON HILL
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20750-0789
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:
12/28/2005

Additional Information

Authorized Official

Authorized Official Last Name:
AZER
Authorized Official First Name:
NIGEL
Authorized Official Middle Name:
M
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
301-839-3373

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 407797100 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




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