Provider Demographics
NPI:1174681894
Name:DRS NEALON FOSTER & GRAVES CHTD
Entity Type:Organization
Organization Name:DRS NEALON FOSTER & GRAVES CHTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT SECRETARY TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:GERARD
Authorized Official - Last Name:NEALON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-654-4850
Mailing Address - Street 1:5530 WISCONSIN AVENUE
Mailing Address - Street 2:SUITE #925
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-4404
Mailing Address - Country:US
Mailing Address - Phone:301-654-4850
Mailing Address - Fax:301-654-3328
Practice Address - Street 1:5530 WISCONSIN AVENUE
Practice Address - Street 2:SUITE #925
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-4404
Practice Address - Country:US
Practice Address - Phone:301-654-4850
Practice Address - Fax:301-654-3328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD430527Medicare PIN