Healthcare Provider Details

I. General information

NPI: 1649306770
Provider Name (Legal Business Name): MARGARET M CLANCY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 33RD ST NW SUITE 115
WASHINGTON DC
20007-3523
US

IV. Provider business mailing address

1015 33RD ST NW SUITE 115
WASHINGTON DC
20007-3523
US

V. Phone/Fax

Practice location:
  • Phone: 202-338-5842
  • Fax: 202-337-0910
Mailing address:
  • Phone: 202-338-5842
  • Fax: 202-337-0910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number7223
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: