Healthcare Provider Details

I. General information

NPI: 1639101157
Provider Name (Legal Business Name): DIANA L ORDIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

VHA-OGP 10G 810 VERMONT AVENUE NW, RM 875F
WASHINGTON DC
20420-0001
US

IV. Provider business mailing address

7981 EASTERN AVE #304
SILVER SPRING MD
20910-4834
US

V. Phone/Fax

Practice location:
  • Phone: 202-273-8305
  • Fax:
Mailing address:
  • Phone: 202-273-8305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number150098
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: