Healthcare Provider Details

I. General information

NPI: 1982023289
Provider Name (Legal Business Name): TOTAL MEDICAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2014
Last Update Date: 04/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6323 GEORGIA AVE NW #210
WASHINGTON DC
20011-1101
US

IV. Provider business mailing address

6323 GEORGIA AVE NW #210
WASHINGTON DC
20011-1101
US

V. Phone/Fax

Practice location:
  • Phone: 202-574-5136
  • Fax:
Mailing address:
  • Phone: 202-574-5136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number StateDC

VIII. Authorized Official

Name: MR. CHRISTOPHER THOMAS ISAACS
Title or Position: MANAGER
Credential:
Phone: 202-574-5136