Healthcare Provider Details

I. General information

NPI: 1780797068
Provider Name (Legal Business Name): GRISELDA PADAOIL TRINIDAD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5028 WISCONSIN AVE NW SUITE 305
WASHINGTON DC
20016-4118
US

IV. Provider business mailing address

5028 WISCONSIN AVE NW SUITE 305
WASHINGTON DC
20016-4118
US

V. Phone/Fax

Practice location:
  • Phone: 202-966-4273
  • Fax: 202-966-4390
Mailing address:
  • Phone: 202-966-4273
  • Fax: 202-966-4390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberMD11124
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: