MEDICARE: ANASTASIA T GYFTOPOULOS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician		DC

General Provider Information

NPI Number	:	1780672022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANASTASIA T GYFTOPOULOS MD

Provider Business Mailing Address
First Line	:	1140 VARNUM ST NE
Second Line	:	STE 040
City	:	WASHINGTON
State	:	DC
Zip	:	20017-2151
Country	:	US
Telephone Number	:	202-529-3577
Fax Number	:	202-635-7432

Provider Business Practice Location Address
First Line	:	1140 VARNUM ST NE
Second Line	:	STE 040
City	:	WASHINGTON
State	:	DC
Zip	:	20017-2151
Country	:	US
Telephone Number	:	202-529-3577
Fax Number	:	202-635-7432

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2005
Last Update Date	:	10/11/2007

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