Healthcare Provider Details

I. General information

NPI: 1962361014
Provider Name (Legal Business Name): ELTON BICALHO DO CARMO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2026
Last Update Date: 01/15/2026
Certification Date: 01/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 13TH ST NW FL 12
WASHINGTON DC
20005-3819
US

IV. Provider business mailing address

19301 MOON RIDGE DR
GERMANTOWN MD
20876-1742
US

V. Phone/Fax

Practice location:
  • Phone: 202-931-9833
  • Fax:
Mailing address:
  • Phone: 202-931-9833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: