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1140 Varnum St Ne Ste 103 Washington DC 20017-2100 | |
| (202) 930-2380 | |
| (202) 464-5554 |
| Full Name | |
|---|---|
| Speciality | Clinic/center |
| Location | 1140 Varnum St Ne Ste 103, Washington, District Of Columbia |
| Authorized Official Name and Position | Mikel Anne Hofmann (MEDICAL DIRECTOR) |
| Authorized Official Contact | 2029302380 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 11192 Takoma Park MD 20913-1192 Ph: (202) 930-2380 | 1140 Varnum St Ne Ste 103 Washington DC 20017-2100 Ph: (202) 930-2380 |
| NPI Number | 1386155539 |
|---|---|
| Provider Enumeration Date | 10/16/2017 |
| Last Update Date | 09/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386155539 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | MD040025 (District Of Columbia) | Primary |
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