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General NPI Number Information
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NPI Number | 1013490267
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Entity Type | Organization
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Legal Business Name | DC PLASTIC SURGERY BOUTIQUE LLC
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Dates
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Enumeration Date | 09/13/2018
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Last Update Date | 09/13/2018
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Provider Practice Location Address
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Address Line | 2440 M ST NW STE 318
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City | WASHINGTON
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State | DC
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Zip | 20037-1472
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Country | US
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Telephone | 202-335-4700
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Fax | 925-993-1234
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Provider Business Mailing Address
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Address Line | 1840 47TH PL NW
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City | WASHINGTON
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State | DC
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Zip | 20007-1909
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Country | US
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Telephone | 202-599-3649
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANITA R KULKARNI
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Credential | MD
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Telephone | 202-599-3649
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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