| Etm,inc | |
|
106 Irving St Nw Ste 403 Washington DC 20010-2989 | |
| (202) 291-1645 | |
| (202) 291-1062 |
| Full Name | Etm,inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 106 Irving St Nw Ste 403, Washington, District Of Columbia |
| Authorized Official Name and Position | Emmanuel Ted Mbualungu (PRESIDENT) |
| Authorized Official Contact | 2022911645 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Etm,inc 106 Irving St Nw Ste 403 Washington DC 20010-2989 Ph: (202) 291-1645 | Etm,inc 106 Irving St Nw Ste 403 Washington DC 20010-2989 Ph: (202) 291-1645 |
| NPI Number | 1609056696 |
|---|---|
| Provider Enumeration Date | 11/07/2007 |
| Last Update Date | 11/07/2007 |
| Medicare PECOS PAC ID | 2062403900 |
|---|---|
| Medicare Enrollment ID | O20040520000279 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609056696 | NPI | - | NPPES |
| 22932100 | Medicaid | DC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 21791 (District Of Columbia) | Primary |
| Provider Name | Emmanuel T Mbualungu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881749166 PECOS PAC ID: 1052302999 Enrollment ID: I20040524000213 |
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