Healthcare Provider Details

I. General information

NPI: 1124193479
Provider Name (Legal Business Name): WASHINGTON NEPHROLOGY ASSOCIATES, L.L.P.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 03/08/2024
Certification Date: 03/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 SEVEN LOCKS RD STE 200
ROCKVILLE MD
20854-2960
US

IV. Provider business mailing address

1201 SEVEN LOCKS RD STE 200A
ROCKVILLE MD
20854-2931
US

V. Phone/Fax

Practice location:
  • Phone: 301-907-4646
  • Fax: 301-907-7796
Mailing address:
  • Phone: 301-907-3939
  • Fax: 301-656-3943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberD0024706
License Number StateMD

VIII. Authorized Official

Name: LINDA LANGFORD
Title or Position: CREDENTIALS COORDINATOR
Credential:
Phone: 301-907-3939