Healthcare Provider Details

I. General information

NPI: 1114586484
Provider Name (Legal Business Name): DISTRICT URGENT CARE PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2019
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2345 MARTIN LUTHER KING JR AVE SE
WASHINGTON DC
20020-5821
US

IV. Provider business mailing address

2345 MARTIN LUTHER KING JR AVE SE
WASHINGTON DC
20020-5821
US

V. Phone/Fax

Practice location:
  • Phone: 202-678-4940
  • Fax: 202-678-9703
Mailing address:
  • Phone: 202-678-4940
  • Fax: 202-678-9703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BLAIN BELAYNEH
Title or Position: OWNER
Credential:
Phone: 202-678-4940