Healthcare Provider Details

I. General information

NPI: 1891811501
Provider Name (Legal Business Name): ALL HEART MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 12/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1647 BENNING RD #201
WASHINGTON DC
20002
US

IV. Provider business mailing address

PO BOX 4427
CAPITOL HEIGHTS MD
20791
US

V. Phone/Fax

Practice location:
  • Phone: 202-399-5707
  • Fax: 202-399-5708
Mailing address:
  • Phone: 202-399-5707
  • Fax: 202-399-5708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD21102
License Number StateDC

VIII. Authorized Official

Name: MRS. GAIL L CHAPMAN
Title or Position: OFFICE MANAGER
Credential:
Phone: 202-399-5707