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General NPI Number Information
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NPI Number | 1396707444
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Entity Type | Individual
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Provider Name | TINA M C REMILLARD PA-C
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Gender | Female
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Dates
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Enumeration Date | 04/04/2006
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 1701 14TH ST NW
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City | WASHINGTON
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State | DC
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Zip | 20009-4308
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Country | US
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Telephone | 202-745-6171
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Fax | 202-745-0238
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Provider Business Mailing Address
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Address Line | 705 DALE DR
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City | SILVER SPRING
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State | MD
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Zip | 20910-4217
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Country | US
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Telephone | 301-920-0996
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA030346
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 011002084
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C03002
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License Number State | MD
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