Provider Demographics
NPI:1083626451
Name:WASHINGTON GASTROENTEROLOGY, PC
Entity Type:Organization
Organization Name:WASHINGTON GASTROENTEROLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOOKKEEPER
Authorized Official - Prefix:MISS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:LAMB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-829-0022
Mailing Address - Street 1:PO BOX 70608
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20813-0608
Mailing Address - Country:US
Mailing Address - Phone:202-829-0022
Mailing Address - Fax:202-829-2927
Practice Address - Street 1:106 IRVING ST NW
Practice Address - Street 2:STE 205
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2927
Practice Address - Country:US
Practice Address - Phone:202-829-0170
Practice Address - Fax:202-829-2927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCC30973OtherMEDICARE RAILROAD
DC409902Medicare PIN