Healthcare Provider Details
I. General information
NPI: 1598027294
Provider Name (Legal Business Name): ASHLEY INCIARDI HUPPE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/09/2012
Last Update Date: 06/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2300 M ST NW
WASHINGTON DC
20037-1434
US
IV. Provider business mailing address
2300 M ST. NW
WASHINGTON DC
20037
US
V. Phone/Fax
- Phone: 202-741-3031
- Fax: 202-742-3029
- Phone: 202-741-3031
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | 9407899 |
| License Number State | KS |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | MD044916 |
| License Number State | DC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: