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General NPI Number Information
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NPI Number | 1487905105
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Entity Type | Organization
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Legal Business Name | METRO RENAL ASSOCIATES, PLLC
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Dates
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Enumeration Date | 09/20/2012
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Last Update Date | 09/26/2012
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Provider Practice Location Address
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Address Line | 106 IRVING ST NW SUITE 2500
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City | WASHINGTON
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State | DC
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Zip | 20010-2927
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Country | US
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Telephone | 202-877-5408
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Fax | 202-722-0505
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Provider Business Mailing Address
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Address Line | 106 IRVING ST NW SUITE 2500
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City | WASHINGTON
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State | DC
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Zip | 20010-2927
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Country | US
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Telephone | 202-877-5408
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Fax | 202-722-0505
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Authorized Official
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Title or Position | PHYSICIAN/PARTNER
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Name | DR. COSETTE O JAMIESON
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Credential | M.D.
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Telephone | 202-877-5408
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | MD19681
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | E23075
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License Number State | DC
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