Healthcare Provider Details

I. General information

NPI: 1225256480
Provider Name (Legal Business Name): U.S. DEPARTMENT OF STATE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 07/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 E STREET NW M-MED-QI, SA-1
WASHINGTON DC
20522-0001
US

IV. Provider business mailing address

2401 E STREET NW M-MED-QI, SA-1
WASHINGTON DC
20522-0001
US

V. Phone/Fax

Practice location:
  • Phone: 202-663-2453
  • Fax: 202-663-3247
Mailing address:
  • Phone: 202-663-2453
  • Fax: 202-663-3247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number StateDC

VIII. Authorized Official

Name: DR. ROBERT G BURNEY
Title or Position: DIRECTOR, QUALITY IMPROVEMENT
Credential: MD
Phone: 202-633-2453