Provider Demographics
NPI:1164835500
Name:HUME, MARY
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:HUME
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3917 22ND ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-3045
Mailing Address - Country:US
Mailing Address - Phone:202-705-2385
Mailing Address - Fax:
Practice Address - Street 1:1010 WISCONSIN AVE NW
Practice Address - Street 2:SUITE300
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-3603
Practice Address - Country:US
Practice Address - Phone:202-935-8355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-03
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA7494163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC2550761OtherMEDSTAR