Healthcare Provider Details

I. General information

NPI: 1922444215
Provider Name (Legal Business Name): NOELLE STARR SHERBER MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2013
Last Update Date: 07/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 15TH ST NW SUITE 100
WASHINGTON DC
20005-5002
US

IV. Provider business mailing address

1101 15TH ST NW SUITE 100
WASHINGTON DC
20005-5002
US

V. Phone/Fax

Practice location:
  • Phone: 202-517-7299
  • Fax: 202-517-7444
Mailing address:
  • Phone: 202-517-7299
  • Fax: 202-517-7444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number0101250650
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number0101250733
License Number StateVA

VIII. Authorized Official

Name: DR. NOELLE S SHERBER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 202-517-7299