1083292254 NPI number — MARY TAYLOR WINSTEN MD

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 1083292254 NPI number — MARY TAYLOR WINSTEN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WINSTEN
Provider First Name:
MARY
Provider Middle Name:
TAYLOR
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TILLMAN
Provider Other First Name:
MARY
Provider Other Middle Name:
TAYLOR
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1083292254
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/30/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
110 IRVING ST NW
Provider Second Line Business Mailing Address:
DEPT OF OB/GYN
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20010-3017
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-877-8035
Provider Business Mailing Address Fax Number:
202-877-5435

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
110 IRVING ST. NW
Provider Second Line Business Practice Location Address:
DEPARTMENT OF OBSTETRICS AND GYNECOLOGY
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-877-8035
Provider Business Practice Location Address Fax Number:
202-877-5435
Provider Enumeration Date:
03/30/2021

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: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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