Healthcare Provider Details

I. General information

NPI: 1467891713
Provider Name (Legal Business Name): CNMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2013
Last Update Date: 06/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1630 COLUMBIA RD NW
WASHINGTON DC
20009-3602
US

IV. Provider business mailing address

1630 COLUMBIA RD NW
WASHINGTON DC
20009-3602
US

V. Phone/Fax

Practice location:
  • Phone: 202-745-2000
  • Fax: 202-939-4717
Mailing address:
  • Phone: 202-745-2000
  • Fax: 202-939-4717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

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