Healthcare Provider Details

I. General information

NPI: 1336111459
Provider Name (Legal Business Name): WASHINGTON HOSPITAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 07/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 IRVING ST NW
WASHINGTON DC
20010-2976
US

IV. Provider business mailing address

PO BOX 631702
BALTIMORE MD
21263-1702
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-6066
  • Fax: 202-877-6601
Mailing address:
  • Phone: 301-562-7881
  • Fax: 301-587-1489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DOUGLAS VANNOSTRAND
Title or Position: PRESIDENT
Credential: MD
Phone: 202-877-6066