Healthcare Provider Details

I. General information

NPI: 1316636509
Provider Name (Legal Business Name): FNU ISHA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2023
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date: 12/07/2023
Reactivation Date: 01/11/2024

III. Provider practice location address

MEDSTAR WASHINGTON HOSPITAL CENTER 110 IRVING ST. NW DEPT OF INTERNAL MEDICINE
WASHINGTON DC DC
20010
US

IV. Provider business mailing address

110 IRVING STREET, NW MEDSTAR HEART & VASCULAR INSTITUTE, SUITE 4B1
WASHINGTON DC DC
20010
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-2835
  • Fax:
Mailing address:
  • Phone: 202-877-5975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD60005718
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: