MEDICARE: DR. FELIPE M DIMAYUGA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2083X0100X	Occupational Medicine Physician	MD13874	DC

General Provider Information

NPI Number	:	1396749677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FELIPE M DIMAYUGA

Provider Business Mailing Address
First Line	:	5800 GOUCHER DR
Second Line	:
City	:	BERWYN HEIGHTS
State	:	MD
Zip	:	20740-2625
Country	:	US
Telephone Number	:	202-767-7300
Fax Number	:	202-404-8154

Provider Business Practice Location Address
First Line	:	455 OVERLOOK AVE,SW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20375-0001
Country	:	US
Telephone Number	:	202-767-7300
Fax Number	:	202-404-8154

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2005
Last Update Date	:	07/08/2007

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