Healthcare Provider Details

I. General information

NPI: 1285888222
Provider Name (Legal Business Name): CHILDREN'S NATIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2008
Last Update Date: 11/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MICHIGAN AVE NW SUITE 1300
WASHINGTON DC
20010-2916
US

IV. Provider business mailing address

111 MICHIGAN AVE NW SUITE 1300
WASHINGTON DC
20010-2916
US

V. Phone/Fax

Practice location:
  • Phone: 202-476-3011
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License NumberPT994
License Number StateDC

VIII. Authorized Official

Name: SUSAN PFENNIG
Title or Position: MANAGER MEDICAL & ACADEMIC AFFAIRS
Credential:
Phone: 202-476-4447