Healthcare Provider Details

I. General information

NPI: 1578342408
Provider Name (Legal Business Name): M MANAGEMENT GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2023
Last Update Date: 09/28/2023
Certification Date: 09/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 7TH ST NE
WASHINGTON DC
20002-7045
US

IV. Provider business mailing address

4806 U ST NW
WASHINGTON DC
20007-1546
US

V. Phone/Fax

Practice location:
  • Phone: 202-543-4800
  • Fax:
Mailing address:
  • Phone: 410-870-9380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: KRYSTLE D BROWN
Title or Position: BILLING MANAGER
Credential:
Phone: 410-870-9380