Healthcare Provider Details
I. General information
NPI: 1629215868
Provider Name (Legal Business Name): CHILDREN' S NATIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/09/2009
Last Update Date: 01/09/2009
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
- Phone: 202-939-4703
- Fax: 202-939-4717
- Phone: 202-939-4703
- Fax: 202-939-4717
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 282NC2000X |
| Taxonomy | Children's Hospital |
| License Number | 04237 |
| License Number State | MD |
VIII. Authorized Official
Name: MRS.
MARGARITA
BAUTISTA -VIGAS
Title or Position: SPEECH-LANGUAGE PATHOLOGIST
Credential: M.A, CCC-SLP
Phone: 202-939-4703