Healthcare Provider Details

I. General information

NPI: 1780628131
Provider Name (Legal Business Name): WASHINGTON ORTHOPAEDICS AND SPORTS MEDICINE, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 05/29/2024
Certification Date: 05/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5550 FRIENDSHIP BLVD STE 360
CHEVY CHASE MD
20815-7256
US

IV. Provider business mailing address

5550 FRIENDSHIP BLVD STE 360
CHEVY CHASE MD
20815-7256
US

V. Phone/Fax

Practice location:
  • Phone: 301-657-1996
  • Fax: 301-951-6160
Mailing address:
  • Phone: 240-483-3762
  • Fax: 301-951-6160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. IVETTE MCNEACE
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 301-657-1996