Healthcare Provider Details

I. General information

NPI: 1457363871
Provider Name (Legal Business Name): JULIO ALEJANDRO SALCEDO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 01/07/2022
Certification Date: 01/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 IRVING ST NW STE 205
WASHINGTON DC
20010-2927
US

IV. Provider business mailing address

12510 PROSPERITY DR SUITE 200
SILVER SPRING MD
20904-1663
US

V. Phone/Fax

Practice location:
  • Phone: 202-829-0170
  • Fax: 202-829-2927
Mailing address:
  • Phone: 240-485-5210
  • Fax: 301-625-6906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number0101047229
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberD0057716
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD21211
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: