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General NPI Number Information
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NPI Number | 1366575599
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Entity Type | Organization
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Legal Business Name | DOTSON & HODGE MEDICAL GROUP, LLC
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 10/20/2007
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Provider Practice Location Address
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Address Line | 650 PENNSYLVANIA AVE SE SUITE 220
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City | WASHINGTON
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State | DC
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Zip | 20003-4318
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Country | US
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Telephone | 202-543-2664
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Fax | 202-546-3244
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Provider Business Mailing Address
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Address Line | 650 PENNSYLVANIA AVE SE SUITE 220
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City | WASHINGTON
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State | DC
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Zip | 20003-4318
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Country | US
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Telephone | 202-543-2664
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Fax | 202-546-3244
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Authorized Official
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Title or Position | PARTNER
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Name | DR. SAMUEL C DOTSON III
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Credential | M.D.
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Telephone | 202-543-2664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 18133
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 17053
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License Number State | DC
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