Healthcare Provider Details

I. General information

NPI: 1851526974
Provider Name (Legal Business Name): JOSE V NABLE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2009
Last Update Date: 08/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 IRVING ST NW SUITE NA 1177
WASHINGTON DC
20010-3017
US

IV. Provider business mailing address

110 IRVING ST NW SUITE NA 1177
WASHINGTON DC
20010-3017
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-4848
  • Fax: 202-877-9263
Mailing address:
  • Phone: 202-877-4848
  • Fax: 202-877-9263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD0073511
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD041971
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: