Provider Demographics
NPI:1134702103
Name:SWEENEY, WILLIAM KYLE III
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:KYLE
Last Name:SWEENEY
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 MAINE AVE SW # E207
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20024-3447
Mailing Address - Country:US
Mailing Address - Phone:202-751-1086
Mailing Address - Fax:
Practice Address - Street 1:449 BURBANK ST SE APT 1
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-4241
Practice Address - Country:US
Practice Address - Phone:202-210-9665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-28
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty