Healthcare Provider Details

I. General information

NPI: 1831516327
Provider Name (Legal Business Name): PCRM CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2014
Last Update Date: 09/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5100 WISCONSIN AVE NW SUITE 401
WASHINGTON DC
20016-4119
US

IV. Provider business mailing address

5100 WISCONSIN AVE NW SUITE 401
WASHINGTON DC
20016-4119
US

V. Phone/Fax

Practice location:
  • Phone: 202-527-7500
  • Fax: 202-527-7400
Mailing address:
  • Phone: 202-527-7500
  • Fax: 202-527-7400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NEAL BARNARD
Title or Position: PRESIDENT
Credential: M.D.
Phone: 202-527-7500