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General NPI Number Information
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NPI Number | 1245615335
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Entity Type | Organization
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Legal Business Name | WELLNESS OF DC
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Dates
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Enumeration Date | 07/30/2015
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Last Update Date | 08/15/2017
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Provider Practice Location Address
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Address Line | 2141 K ST NW STE 808
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City | WASHINGTON
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State | DC
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Zip | 20037-1810
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Country | US
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Telephone | 202-487-5179
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Fax | 202-331-4969
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Provider Business Mailing Address
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Address Line | 2141 K ST NW STE 808
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City | WASHINGTON
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State | DC
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Zip | 20037-1810
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Country | US
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Telephone | 202-487-5179
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Fax | 202-331-4969
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Authorized Official
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Title or Position | OWNER
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Name | JULIAN EDWIN SAFRAN
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Credential | MD
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Telephone | 202-487-5176
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | MD9583
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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