Basic Information
| Provider Information | |||||||||
| NPI: | 1063684330 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | WASHINGTON HOSPITAL CENTER CORP | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | WASHINGTON HOSPITAL CENTER PHYSICIANS | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6525 BELCREST RD. | ||||||||
| Address2: | STE 320 WHC-PBS | ||||||||
| City: | HYATTSVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207822022 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3012095612 | ||||||||
| FaxNumber: | 3012095656 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 HOSPITAL RD | ||||||||
| Address2: | |||||||||
| City: | PRINCE FREDERICK | ||||||||
| State: | MD | ||||||||
| PostalCode: | 206784017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018551012 | ||||||||
| FaxNumber: | 3012095656 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2008 | ||||||||
| LastUpdateDate: | 05/13/2009 | ||||||||
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| AuthorizedOfficialLastName: | ORLOWSKI | ||||||||
| AuthorizedOfficialFirstName: | JANIS | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | SNR VICE PRES. AND CHIEF MED. OFF. | ||||||||
| AuthorizedOfficialTelephone: | 2028775284 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0129X | HFD01-0210 | DC | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery |
No ID Information.