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General NPI Number Information
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NPI Number | 1497129191
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Entity Type | Organization
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Legal Business Name | DBH- SAINT ELIZABETHS HOSPITAL
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Dates
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Enumeration Date | 11/18/2015
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Last Update Date | 11/18/2015
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Provider Practice Location Address
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Address Line | 1100 ALABAMA AVE SE SAINT ELIZABETHS HOSPITAL-DBH ROOM # 238.01
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City | WASHINGTON
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State | DC
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Zip | 20032
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Country | US
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Telephone | 202-299-5360
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Fax |
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Provider Business Mailing Address
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Address Line | 3901 SUITLAND RD APT# 1014
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City | SUITLAND
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State | MD
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Zip | 20746-1955
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Country | US
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Telephone | 559-905-0332
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Fax |
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Authorized Official
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Title or Position | DIRECTOR PSYCHIATRY RESIDENCY
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Name | FAROOQ MOHYUDDIN
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Credential | M.D.
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Telephone | 202-299-5360
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | MTL002903
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License Number State | DC
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