Healthcare Provider Details
I. General information
NPI: 1427145176
Provider Name (Legal Business Name): MEDSTAR - GEORGETOWN MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/06/2006
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3800 RESERVOIR RD., NW
WASHINGTON DC
20007-2113
US
IV. Provider business mailing address
2000 15TH ST., N SUITE 401
ARLINGTON VA
22201-2683
US
V. Phone/Fax
- Phone: 202-444-3000
- Fax: 202-444-3095
- Phone: 703-558-1653
- Fax: 703-558-1650
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QE0700X |
| Taxonomy | End-Stage Renal Disease (ESRD) Treatment Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 273R00000X |
| Taxonomy | Psychiatric Hospital Unit |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 282N00000X |
| Taxonomy | General Acute Care Hospital |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
DAVID
C
HO
Title or Position: VP OF FINANCE
Credential:
Phone: 202-444-4724