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General NPI Number Information
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NPI Number | 1518136035
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Entity Type | Organization
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Legal Business Name | EAR,NOSE & THROAT MEDICAL GROUP OF WASHINGTON P.C.
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Dates
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Enumeration Date | 02/28/2008
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Last Update Date | 06/12/2008
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Provider Practice Location Address
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Address Line | 2021 K ST NW SUITE 210
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City | WASHINGTON
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State | DC
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Zip | 20006-1003
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Country | US
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Telephone | 202-223-3560
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Fax | 202-223-3339
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Provider Business Mailing Address
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Address Line | 2021 K ST NW SUITE 210
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City | WASHINGTON
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State | DC
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Zip | 20006-1003
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Country | US
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Telephone | 202-223-3560
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Fax | 202-223-3339
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES GORDON VAP
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Credential | M.D.
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Telephone | 202-223-3560
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | MD3439
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License Number State | DC
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