Healthcare Provider Details
I. General information
NPI: 1184850851
Provider Name (Legal Business Name): IAN MURDOCK WARRINGTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/08/2009
Last Update Date: 12/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5255 LOUGHBORO RD NW
WASHINGTON DC
20016-2633
US
IV. Provider business mailing address
1750 16TH ST NW APARTMENT #12
WASHINGTON DC
20009-3147
US
V. Phone/Fax
- Phone: 202-537-4080
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | MD041159 |
| License Number State | DC |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | 0101253678 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: