| D/b/a Capitol Medical Center Group Practice | |
|
1310 Southern Ave Se Washington DC 20032-4623 | |
| (202) 574-6837 | |
| (202) 574-7188 |
| Full Name | D/b/a Capitol Medical Center Group Practice |
|---|---|
| Speciality | General Practice |
| Location | 1310 Southern Ave Se, Washington, District Of Columbia |
| Authorized Official Name and Position | John Montois (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 2025746837 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| D/b/a Capitol Medical Center Group Practice 1310 Southern Ave Se Washington DC 20032-4623 Ph: (202) 574-6837 | D/b/a Capitol Medical Center Group Practice 1310 Southern Ave Se Washington DC 20032-4623 Ph: (202) 574-6837 |
| NPI Number | 1871756817 |
|---|---|
| Provider Enumeration Date | 07/09/2008 |
| Last Update Date | 05/21/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871756817 | NPI | - | NPPES |
| 090008 | Other | DC | MEDICARE ACUTE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | HFDO10198 (District Of Columbia) | Primary |
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