Healthcare Provider Details

I. General information

NPI: 1265452635
Provider Name (Legal Business Name): WASHINGTON HOSPITAL CENTER CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 11/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 IRVING ST NW
WASHINGTON DC
20010-2976
US

IV. Provider business mailing address

11510 GEORGIA AVE SUITE 206
WHEATON MD
20902-1925
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-7575
  • Fax: 202-877-3081
Mailing address:
  • Phone: 301-946-5100
  • Fax: 301-929-0348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBBERT PORCO
Title or Position: ADMINISTRATIVE DIRECTOR/ANESTHESIOL
Credential:
Phone: 202-877-7575