MEDICARE: DR. AURELIO JOSEPH OGILVIE

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	103TC0700X	Clinical Psychologist	0810004820	VA

General Provider Information

NPI Number	:	1932359288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AURELIO JOSEPH OGILVIE

Provider Business Mailing Address
First Line	:	1002 E CAPITOL ST NE BSMT SUITE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20003-3906
Country	:	US
Telephone Number	:	202-552-1741
Fax Number	:

Provider Business Practice Location Address
First Line	:	1002 E CAPITOL ST NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20003-3906
Country	:	US
Telephone Number	:	202-552-1741
Fax Number	:

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

Provider Enumeration Date	:	09/23/2008
Last Update Date	:	08/29/2023

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