Healthcare Provider Details

I. General information

NPI: 1942261706
Provider Name (Legal Business Name): GASTROINTESTINAL ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 02/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1160 VARNUM ST NE 311
WASHINGTON DC
20017-2107
US

IV. Provider business mailing address

1160 VARNUM ST NE 311
WASHINGTON DC
20017-2107
US

V. Phone/Fax

Practice location:
  • Phone: 202-832-2880
  • Fax: 202-832-0456
Mailing address:
  • Phone: 202-832-2880
  • Fax: 202-832-0456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: KENNETH MAXWELL BROWN
Title or Position: CHAIRMAN OF THE BOARD
Credential: MD
Phone: 202-832-2880