Healthcare Provider Details

I. General information

NPI: 1609876143
Provider Name (Legal Business Name): ANN ELIZABETH MEDINGER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2005
Last Update Date: 07/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2440 M ST NW SUITE 810
WASHINGTON DC
20037-1404
US

IV. Provider business mailing address

2440 M ST NW SUITE 810
WASHINGTON DC
20037-1404
US

V. Phone/Fax

Practice location:
  • Phone: 202-775-0860
  • Fax: 202-835-9040
Mailing address:
  • Phone: 202-775-0860
  • Fax: 202-835-9040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number10184
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: