Healthcare Provider Details

I. General information

NPI: 1396531422
Provider Name (Legal Business Name): MEDICAL FACULTY ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2025
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 PECAN ST SE
WASHINGTON DC
20032-2652
US

IV. Provider business mailing address

2150 PENNSYLVANIA AVE NW STE 10-409A
WASHINGTON DC
20037-3201
US

V. Phone/Fax

Practice location:
  • Phone: 771-444-6200
  • Fax:
Mailing address:
  • Phone: 202-741-3350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207ZB0001X
TaxonomyBlood Banking & Transfusion Medicine Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY COLLIC
Title or Position: SR. DIRECTOR, REVENUE CYCLE
Credential:
Phone: 202-741-2411