Healthcare Provider Details

I. General information

NPI: 1881674877
Provider Name (Legal Business Name): JOHN GEORGE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2006
Last Update Date: 06/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 VARNUM ST NE
WASHINGTON DC
20017-2104
US

IV. Provider business mailing address

1150 VARNUM ST NE
WASHINGTON DC
20017-2104
US

V. Phone/Fax

Practice location:
  • Phone: 202-854-7439
  • Fax: 202-854-7470
Mailing address:
  • Phone: 202-854-7439
  • Fax: 202-854-7470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberDC5598
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: