1467755967 NPI number — ESTHER C. ESTWICK, MD, INC

Table of content: (NPI 1467755967)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467755967 NPI number — ESTHER C. ESTWICK, MD, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ESTHER C. ESTWICK, MD, INC
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:
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:
1467755967
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/06/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9470 ANNAPOLIS RD STE 305
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LANHAM
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20706-3022
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-459-8868
Provider Business Mailing Address Fax Number:
301-459-8869

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9470 ANNAPOLIS RD STE 305
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LANHAM
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20706-3022
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-459-8868
Provider Business Practice Location Address Fax Number:
301-459-8869
Provider Enumeration Date:
12/06/2010

Additional Information

Authorized Official

Authorized Official Last Name:
ESTWICK
Authorized Official First Name:
ESTHER
Authorized Official Middle Name:
CECELIA
Authorized Official Title or Position:
PSYCHIATRIST
Authorized Official Telephone Number:
301-459-8868

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X , with the licence number:  D0018134 , 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)

  • Identifier: 514250 . This is a "MEDICARE OF WASHINGTON, DC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 396821900 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 003120 . This is a "VALU OPTIONS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 008182 . This is a "BLUE CROSS BLUE SHIELD FEDERAL" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 2978 . This is a "BLUE CROSS BLUE SHIELD OF MARYLAND" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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