Basic Information
| Provider Information | |||||||||
| NPI: | 1578878484 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MEDICAL FACULTY ASSOCIATES | ||||||||
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| OtherOrganizationName: | FACULTY PRACTICE PLAN HOWARD UNIVERSITY | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2024 GEORGIA AVE NW | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200013027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2025953223 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6315 5TH ST NW | ||||||||
| Address2: | SCHOOL HEALTH CENTER | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200111325 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2028654164 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/16/2010 | ||||||||
| LastUpdateDate: | 08/17/2010 | ||||||||
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| AuthorizedOfficialLastName: | MCCLAIN | ||||||||
| AuthorizedOfficialFirstName: | PAMELA | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR OF BUSINESS OPERATIONS | ||||||||
| AuthorizedOfficialTelephone: | 2027413650 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QS1000X | Y | Ambulatory Health Care Facilities | Clinic/Center | Student Health |
No ID Information.