Basic Information
| Provider Information | |||||||||
| NPI: | 1194879445 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ENGEL | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | I. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | |||||||||
| Mailing Information | |||||||||
| Address1: | 1145 19TH ST NW | ||||||||
| Address2: | SUITE 410 | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200363701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2023311740 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1145 19TH ST NW | ||||||||
| Address2: | SUITE 410 | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200363701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2023311740 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/23/2007 | ||||||||
| LastUpdateDate: | 10/01/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | MD301119 | DC | Y | Other Service Providers | Specialist |
No ID Information.