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General NPI Number Information
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NPI Number | 1528525797
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Entity Type | Organization
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Legal Business Name | SUSHMA GOYAL
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Dates
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Enumeration Date | 02/25/2019
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Last Update Date | 02/25/2019
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Provider Practice Location Address
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Address Line | 1328 SOUTHERN AVE SE STE 316
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City | WASHINGTON
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State | DC
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Zip | 20032-4689
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Country | US
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Telephone | 202-562-4100
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Fax | 201-562-4101
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Provider Business Mailing Address
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Address Line | 10821 BARN WOOD LN
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City | POTOMAC
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State | MD
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Zip | 20854-1329
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Country | US
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Telephone | 301-299-4944
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Fax | 202-562-4101
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Authorized Official
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Title or Position | OWNER
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Name | DR. SUSHMA GOYAL
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Credential | MD
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Telephone | 202-562-4100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0000X
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Taxonomy Name | Adolescent Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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