Healthcare Provider Details

I. General information

NPI: 1104072958
Provider Name (Legal Business Name): MICHAEL BROWNING HAWKINS D.P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2008
Last Update Date: 03/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 RESERVOIR RD NW ROOM CG-12, BLES BUILDING
WASHINGTON DC
20007-2113
US

IV. Provider business mailing address

3800 RESERVOIR RD NW ROOM CG-12, BLES BUILDING
WASHINGTON DC
20007-2113
US

V. Phone/Fax

Practice location:
  • Phone: 202-444-3690
  • Fax:
Mailing address:
  • Phone: 202-444-3690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT870903
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: