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General NPI Number Information
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NPI Number | 1083371454
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Entity Type | Organization
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Legal Business Name | KATALYST HEALTHCARE CORPORATION
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Dates
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Enumeration Date | 11/20/2021
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Last Update Date | 11/26/2021
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Provider Practice Location Address
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Address Line | 11350 RANDOM HILLS RD STE 800
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City | FAIRFAX
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State | VA
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Zip | 22030-6044
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Country | US
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Telephone | 202-734-1298
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Fax |
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Provider Business Mailing Address
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Address Line | 9893 GEORGETOWN PIKE STE 143
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City | GREAT FALLS
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State | VA
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Zip | 22066-2617
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Country | US
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Telephone | 703-263-8399
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Fax |
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Authorized Official
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Title or Position | COO/CMO
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Name | DR. MARC NELSON, MD
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Credential | MD
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Telephone | 703-982-6988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1100X
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Taxonomy Name | Research Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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