Healthcare Provider Details

I. General information

NPI: 1164463675
Provider Name (Legal Business Name): CANDACE SCALES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2041 GEORGIA AVE NW
WASHINGTON DC
20060-0001
US

IV. Provider business mailing address

2024 GEORGIA AVE NW
WASHINGTON DC
20001-3002
US

V. Phone/Fax

Practice location:
  • Phone: 202-865-1121
  • Fax: 202-865-4492
Mailing address:
  • Phone: 202-865-3415
  • Fax: 202-865-6876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License NumberMD13405
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: