Healthcare Provider Details

I. General information

NPI: 1972700334
Provider Name (Legal Business Name): THERESA MICHELLE CARIDI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 02/01/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 RESERVOIR RD NW CG201
WASHINGTON DC
20007-2113
US

IV. Provider business mailing address

3800 RESERVOIR RD NW CG201
WASHINGTON DC
20007-2113
US

V. Phone/Fax

Practice location:
  • Phone: 202-444-3450
  • Fax: 202-444-4899
Mailing address:
  • Phone: 202-444-3450
  • Fax: 202-444-4899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number40785
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberMT201031
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: