Healthcare Provider Details

I. General information

NPI: 1235688896
Provider Name (Legal Business Name): SUGARBAKER HONG SURGICAL ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2016
Last Update Date: 09/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 IRVING ST NW STE. 3900
WASHINGTON DC
20010-2927
US

IV. Provider business mailing address

106 IRVING ST NW STE. 3900
WASHINGTON DC
20010-2927
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-3908
  • Fax:
Mailing address:
  • Phone: 202-877-3908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberMD038999
License Number StateDC

VIII. Authorized Official

Name: DR. PAUL HENDRICK SUGARBAKER
Title or Position: DIRECTOR
Credential: MD
Phone: 202-877-3908