Healthcare Provider Details

I. General information

NPI: 1780708669
Provider Name (Legal Business Name): DIDACE KABATSI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

818 18TH ST NW STE 620
WASHINGTON DC
20006-3513
US

IV. Provider business mailing address

818 18TH ST NW STE 620
WASHINGTON DC
20006-3513
US

V. Phone/Fax

Practice location:
  • Phone: 202-822-9600
  • Fax: 202-822-8099
Mailing address:
  • Phone: 202-822-9600
  • Fax: 202-822-8099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD9107
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: