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1160 Varnum St Ne Ste 111 Washington DC 20017-2110 | |
| (202) 269-0381 | |
| (202) 269-0390 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine - Endocrinology, Diabetes & Metabolism |
| Location | 1160 Varnum St Ne Ste 111, Washington, District Of Columbia |
| Authorized Official Name and Position | Abbas Motazedi (CEO) |
| Authorized Official Contact | 2022690381 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 1410 Great Falls VA 22066-8410 Ph: () - | 1160 Varnum St Ne Ste 111 Washington DC 20017-2110 Ph: (202) 269-0381 |
| NPI Number | 1568667996 |
|---|---|
| Provider Enumeration Date | 06/16/2007 |
| Last Update Date | 07/10/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568667996 | NPI | - | NPPES |
| 011001500 | Medicaid | DC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | MD11580 (District Of Columbia) | Primary |
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