Provider Demographics
NPI:1205826450
Name:DUPONT III PC
Entity Type:Organization
Organization Name:DUPONT III PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:OCUIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-882-2500
Mailing Address - Street 1:106 IRVING ST NW
Mailing Address - Street 2:SUITE 418
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2927
Mailing Address - Country:US
Mailing Address - Phone:202-882-2500
Mailing Address - Fax:202-726-8076
Practice Address - Street 1:106 IRVING ST NW
Practice Address - Street 2:SUITE 418
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2927
Practice Address - Country:US
Practice Address - Phone:202-882-2500
Practice Address - Fax:202-726-8076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-27
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC022271100Medicaid
458MMedicare ID - Type Unspecified
160170Medicare ID - Type Unspecified