=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750811964
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KIRSTI ANNE CAMPBELL MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/20/2017
-----------------------------------------------------
Last Update Date | 09/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 125 POTOMAC PSGE STE 250
-----------------------------------------------------
City | NATIONAL HARBOR
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20745-1580
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-737-0085
-----------------------------------------------------
Fax | 202-296-0301
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10770 COLUMBIA PIKE STE 400
-----------------------------------------------------
City | SILVER SPRING
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20901-4462
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-589-9012
-----------------------------------------------------
Fax | 833-705-6301
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RG0100X
-----------------------------------------------------
Taxonomy Name | Gastroenterology Physician
-----------------------------------------------------
License Number | MD210003160
-----------------------------------------------------
License Number State | DC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RG0100X
-----------------------------------------------------
Taxonomy Name | Gastroenterology Physician
-----------------------------------------------------
License Number | D0096822
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------