Healthcare Provider Details

I. General information

NPI: 1619383544
Provider Name (Legal Business Name): JULIE HAIMES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2014
Last Update Date: 07/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 IRVING ST NW
WASHINGTON DC
20010-3017
US

IV. Provider business mailing address

110 IRVING ST NW
WASHINGTON DC
20010-3017
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-5392
  • Fax: 202-877-0977
Mailing address:
  • Phone: 202-877-5392
  • Fax: 202-877-0977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License NumberPA030469
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: