Basic Information
Provider Information
NPI: 1851526974
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NABLE
FirstName: JOSE
MiddleName: V
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 110 IRVING ST NW
Address2: SUITE NA 1177
City: WASHINGTON
State: DC
PostalCode: 200103017
CountryCode: US
TelephoneNumber: 2028774848
FaxNumber: 2028779263
Practice Location
Address1: 110 IRVING ST NW
Address2: SUITE NA 1177
City: WASHINGTON
State: DC
PostalCode: 200103017
CountryCode: US
TelephoneNumber: 2028774848
FaxNumber: 2028779263
Other Information
ProviderEnumerationDate: 05/19/2009
LastUpdateDate: 08/05/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000XD0073511MDN Allopathic & Osteopathic PhysiciansEmergency Medicine 
207P00000XMD041971DCY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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