Healthcare Provider Details

I. General information

NPI: 1669422960
Provider Name (Legal Business Name): AUGUSTO DESCALZI PICHARD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 03/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 IRVING ST NW ROOM # 4B-1
WASHINGTON DC
20010-2976
US

IV. Provider business mailing address

110 IRVING ST NW ROOM # 4B-1
WASHINGTON DC
20010-2976
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-2700
  • Fax: 202-877-2718
Mailing address:
  • Phone: 202-877-2700
  • Fax: 202-877-2718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberMD13927
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD13927
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: