Healthcare Provider Details

I. General information

NPI: 1326468562
Provider Name (Legal Business Name): ADAM J VISCONTI MD MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2014
Last Update Date: 08/18/2021
Certification Date: 08/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 P ST NE
WASHINGTON DC
20002-3350
US

IV. Provider business mailing address

3119 QUESADA ST NW
WASHINGTON DC
20015-1612
US

V. Phone/Fax

Practice location:
  • Phone: 202-741-7692
  • Fax:
Mailing address:
  • Phone: 415-509-3062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberMD046260
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: