Healthcare Provider Details

I. General information

NPI: 1134353659
Provider Name (Legal Business Name): MARIA CECILIA EGUIGUREN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2009
Last Update Date: 08/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 RESERVOIR RD NW PHC BLDG 3RD FLOOR DEPARTMENT OF OBGYN
WASHINGTON DC
20007-2113
US

IV. Provider business mailing address

3800 RESERVOIR RD NW BLDG 3 DEPARTMENT OF OBGYN
WASHINGTON DC
20007-2113
US

V. Phone/Fax

Practice location:
  • Phone: 202-444-8531
  • Fax:
Mailing address:
  • Phone: 202-444-8531
  • Fax: 187-754-4775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD041680
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: