Healthcare Provider Details

I. General information

NPI: 1255330411
Provider Name (Legal Business Name): GEORGE KOLODNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3204 KLINGLE RD NW
WASHINGTON DC
20008-3403
US

IV. Provider business mailing address

3204 KLINGLE RD NW
WASHINGTON DC
20008-3403
US

V. Phone/Fax

Practice location:
  • Phone: 202-215-3565
  • Fax: 410-705-0178
Mailing address:
  • Phone: 202-215-3565
  • Fax: 410-705-0178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number5233
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: