Healthcare Provider Details

I. General information

NPI: 1366517013
Provider Name (Legal Business Name): GREATER WASHINGTON MEDICENTER LLC. T/A HEALTHCARE OF GREATER WASHINGTO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6357 OXON HILL RD
OXON HILL MD
20745-2214
US

IV. Provider business mailing address

6357 OXON HILL RD
OXON HILL MD
20745-2214
US

V. Phone/Fax

Practice location:
  • Phone: 301-839-2820
  • Fax: 301-839-1354
Mailing address:
  • Phone: 301-358-0002
  • Fax: 301-839-1354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number StateMD

VIII. Authorized Official

Name: DR. STEPHEN T ONG
Title or Position: MD OWNER
Credential:
Phone: 301-839-2700