=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588828149
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DR. ALEJANDRO LUINA CONTRERAS
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/14/2008
-----------------------------------------------------
Last Update Date | 07/26/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 606 STEPHEN SITTER AVE
-----------------------------------------------------
City | SILVER SPRING
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20910-1290
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-295-5256
-----------------------------------------------------
Fax | 301-295-5675
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 606 STEPHEN SITTER AVE JOINT PATHOLOGY CENTER
-----------------------------------------------------
City | SILVER SPRING
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20910
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207ZP0102X
-----------------------------------------------------
Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
-----------------------------------------------------
License Number | 247261
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207ZP0102X
-----------------------------------------------------
Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
-----------------------------------------------------
License Number | MD036543
-----------------------------------------------------
License Number State | DC
-----------------------------------------------------