Healthcare Provider Details

I. General information

NPI: 1952440166
Provider Name (Legal Business Name): DENNIS R WIRT MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 PENNSYLVANIA AVE. SE 310
WASHINGTON DC
20003
US

IV. Provider business mailing address

801 PENNSYLVANIA AVE. SE 310
WASHINGTON DC
20003
US

V. Phone/Fax

Practice location:
  • Phone: 202-547-3100
  • Fax: 202-547-0722
Mailing address:
  • Phone: 202-547-3100
  • Fax: 202-547-0722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: JANICE C DIGGS
Title or Position: BUSINESS MANAGER ADMIN
Credential:
Phone: 202-547-3100