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General NPI Number Information
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NPI Number | 1396749677
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Entity Type | Individual
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Provider Name | DR. FELIPE M DIMAYUGA
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Gender | Male
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Dates
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Enumeration Date | 06/02/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 455 OVERLOOK AVE,SW
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City | WASHINGTON
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State | DC
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Zip | 20375-0001
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Country | US
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Telephone | 202-767-7300
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Fax | 202-404-8154
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Provider Business Mailing Address
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Address Line | 5800 GOUCHER DR
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City | BERWYN HEIGHTS
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State | MD
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Zip | 20740-2625
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Country | US
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Telephone | 202-767-7300
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Fax | 202-404-8154
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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 | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | MD13874
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License Number State | DC
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