Provider Demographics
NPI:1154506533
Name:PRIMARY CARE AT FOXHALL
Entity Type:Organization
Organization Name:PRIMARY CARE AT FOXHALL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:DR
Authorized Official - First Name:ANJULA
Authorized Official - Middle Name:
Authorized Official - Last Name:AGRAWAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-895-0050
Mailing Address - Street 1:3301 NEW MEXICO AVE
Mailing Address - Street 2:SUITE #205
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016
Mailing Address - Country:US
Mailing Address - Phone:202-895-0050
Mailing Address - Fax:202-895-0051
Practice Address - Street 1:3301 NEW MEXICO AVE
Practice Address - Street 2:SUITE #205
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016
Practice Address - Country:US
Practice Address - Phone:202-895-0050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-04
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G40382Medicare UPIN
G757Medicare UPIN