| Guh Kids Mobile Medical Clinic Program, Llc | |
|
4225 6th St Se Washington DC 20032-3613 | |
| (202) 468-4816 | |
| Not Available |
| Full Name | Guh Kids Mobile Medical Clinic Program, Llc |
|---|---|
| Speciality | General Practice |
| Location | 4225 6th St Se, Washington, District Of Columbia |
| Authorized Official Name and Position | Stephanie Schneider (VP) |
| Authorized Official Contact | 7025581403 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Guh Kids Mobile Medical Clinic Program, Llc Po Box 418283 Boston MA 02241-8283 Ph: (703) 558-1400 | Guh Kids Mobile Medical Clinic Program, Llc 4225 6th St Se Washington DC 20032-3613 Ph: (202) 468-4816 |
| NPI Number | 1194374710 |
|---|---|
| Provider Enumeration Date | 09/06/2019 |
| Last Update Date | 09/06/2019 |
| Medicare PECOS PAC ID | 8426389990 |
|---|---|
| Medicare Enrollment ID | O20191015000258 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194374710 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Michelle Roett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821013236 PECOS PAC ID: 3971505603 Enrollment ID: I20070209000265 |
| Provider Name | Eileen S Moore |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053309427 PECOS PAC ID: 2769519081 Enrollment ID: I20100419000417 |
| Provider Name | Stephen Mitchell |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1194713503 PECOS PAC ID: 9234267857 Enrollment ID: I20100503000125 |
| Provider Name | Tobie-lynn Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083747091 PECOS PAC ID: 3375609035 Enrollment ID: I20111201000307 |
| Provider Name | Swati Chanani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417362443 PECOS PAC ID: 4688894082 Enrollment ID: I20200805000231 |
| Provider Name | Karen Gayle Ganacias |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1174834865 PECOS PAC ID: 6901224039 Enrollment ID: I20200922000696 |
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