Healthcare Provider Details

I. General information

NPI: 1790282846
Provider Name (Legal Business Name): CHRISTOPHER PAYETTE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2018
Last Update Date: 03/17/2022
Certification Date: 03/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

THE GW MEDICAL FACULTY ASSOCIATES 2150 PENNSYLVANIA AVENUE NW
WASHINGTON DC
20037
US

IV. Provider business mailing address

2120 L ST NW STE 450
WASHINGTON DC
20037-1541
US

V. Phone/Fax

Practice location:
  • Phone: 202-741-3000
  • Fax:
Mailing address:
  • Phone: 202-715-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD210001958
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: