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General NPI Number Information
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NPI Number | 1215341763
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Entity Type | Organization
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Legal Business Name | MEDICAL FACULTY ASSOCIATES
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Dates
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Enumeration Date | 06/12/2014
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Last Update Date | 06/12/2014
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Provider Practice Location Address
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Address Line | 2150 PENNSYLVANIA AVE NW SUITE 6-B
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City | WASHINGTON
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State | DC
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Zip | 20037-3201
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Country | US
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Telephone | 202-741-3203
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Fax | 202-741-3219
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Provider Business Mailing Address
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Address Line | 2150 PENNSYLVANIA AVE NW SUITE 6-B
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City | WASHINGTON
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State | DC
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Zip | 20037-3201
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Country | US
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Telephone | 202-741-3203
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Fax | 202-741-3219
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Authorized Official
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Title or Position | CEO
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Name | STEPHEN BADGER
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Credential |
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Telephone | 202-741-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN965339
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License Number State | DC
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