Healthcare Provider Details

I. General information

NPI: 1013989896
Provider Name (Legal Business Name): WASHINGTON METROPOLITAN PRACTICE PLAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 IRVING ST NW RM 4B42/4B39
WASHINGTON DC
20010-2976
US

IV. Provider business mailing address

1201 SEVEN LOCKS RD SUITE 200
ROCKVILLE MD
20854-2931
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-7259
  • Fax: 202-877-7258
Mailing address:
  • Phone: 301-652-5771
  • Fax: 301-652-6332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ARTHUR ST. ANDRE
Title or Position: DIRECTOR
Credential: MD
Phone: 202-877-7259