Healthcare Provider Details

I. General information

NPI: 1780853929
Provider Name (Legal Business Name): CHILDREN'S NATIONAL MEDCIAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2008
Last Update Date: 02/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MICHIGAN AVE NW
WASHINGTON DC
20010-2978
US

IV. Provider business mailing address

111 MICHIGAN AVE NW
WASHINGTON DC
20010-2978
US

V. Phone/Fax

Practice location:
  • Phone: 202-476-5600
  • Fax: 202-476-2163
Mailing address:
  • Phone: 202-476-5600
  • Fax: 202-476-2163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number2101001446
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number01022
License Number StateMD

VIII. Authorized Official

Name: SHEELA L STUART
Title or Position: DIRECTOR
Credential: PHD
Phone: 202-476-5600