Healthcare Provider Details

I. General information

NPI: 1558729681
Provider Name (Legal Business Name): DC DEPARTMENT OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2016
Last Update Date: 02/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 MASSACHUSETTS AVE SE
WASHINGTON DC
20003-2542
US

IV. Provider business mailing address

899 N CAPITOL ST NE 4TH FLOOR
WASHINGTON DC
20002-4263
US

V. Phone/Fax

Practice location:
  • Phone: 202-671-4821
  • Fax:
Mailing address:
  • Phone: 202-671-4821
  • Fax:

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. TRAVIS GAYLES
Title or Position: CHIEF MEDICAL OFFICER
Credential: MD, PHD
Phone: 202-671-4821