Basic Information
| Provider Information | |||||||||
| NPI: | 1851958672 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STEINWACHS | ||||||||
| FirstName: | BRADLEY | ||||||||
| MiddleName: | HAROLD | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1100 ALABAMA AVE SE STE 238 | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200324542 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2022995334 | ||||||||
| FaxNumber: | 8034344062 | ||||||||
| Practice Location | |||||||||
| Address1: | 1100 ALABAMA AVE SE STE 238 | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200324542 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2022995334 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/28/2019 | ||||||||
| LastUpdateDate: | 06/30/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/30/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | LL82604 | SC | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 390200000X | MTL005893 | DC | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.