Basic Information
| Provider Information | |||||||||
| NPI: | 1285769414 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | STUART SIBEL DPM & LEE E FIRESTONE DPM PC | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 2021 K ST NW | ||||||||
| Address2: | 520 | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200061003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2022234616 | ||||||||
| FaxNumber: | 2022230740 | ||||||||
| Practice Location | |||||||||
| Address1: | 2021 K ST NW | ||||||||
| Address2: | 520 | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200061003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2022234616 | ||||||||
| FaxNumber: | 2022230740 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/21/2007 | ||||||||
| LastUpdateDate: | 10/02/2008 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | SIBEL | ||||||||
| AuthorizedOfficialFirstName: | STUART | ||||||||
| AuthorizedOfficialMiddleName: | BRIAN | ||||||||
| AuthorizedOfficialTitleorPosition: | PODIATRIST | ||||||||
| AuthorizedOfficialTelephone: | 2022234616 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | DPM | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213ES0103X | PO423 | DC | Y | 193400000X SINGLE SPECIALTY GROUP | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot & Ankle Surgery |
ID Information
| ID | Type | State | Issuer | Description | 037039100 | 05 | DC | MEDICAID | 027420300 | 05 | DC | MEDICAID | 027419600 | 05 | DC | MEDICAID | CH2741 | 01 | RETIRED RAILROAD GROUP NUMBER | OTHER |