Healthcare Provider Details

I. General information

NPI: 1336561448
Provider Name (Legal Business Name): DISTRICT OF COLUMBIA DEPARTMENT OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2014
Last Update Date: 01/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 MASSACHUSETTS AVE SE, BLDG 15 STD/ TB CLINIC
WASHINGTON DC
20003
US

IV. Provider business mailing address

899 NORTH CAPITAL STREET NE ROOM 4000 DISTRICT OF COLUMBIA DEPART. OF HEALTH, STD/ TB DN
WASHINGTON DC
20002
US

V. Phone/Fax

Practice location:
  • Phone: 202-698-4044
  • Fax:
Mailing address:
  • Phone: 202-671-4843
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. JEANNETTE MARIE HINNANT
Title or Position: DEPUTY STD/ TB DIRECTOR
Credential:
Phone: 202-698-4035