Provider Demographics
NPI:1265452635
Name:WASHINGTON HOSPITAL CENTER CORP
Entity Type:Organization
Organization Name:WASHINGTON HOSPITAL CENTER CORP
Other - Org Name:CENTER ANESTHESIOLOGY
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR/ANESTHESIOL
Authorized Official - Prefix:
Authorized Official - First Name:ROBBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:PORCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-877-7575
Mailing Address - Street 1:11510 GEORGIA AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:WHEATON
Mailing Address - State:MD
Mailing Address - Zip Code:20902-1925
Mailing Address - Country:US
Mailing Address - Phone:301-946-5100
Mailing Address - Fax:301-929-0348
Practice Address - Street 1:110 IRVING ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2976
Practice Address - Country:US
Practice Address - Phone:202-877-7575
Practice Address - Fax:202-877-3081
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDSTAR HEALTH INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-20
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC284421OtherMAMSI
MD061801200Medicaid
DC2200OtherCAREFIRST BCBS
DC027447100Medicaid
DC2037700OtherUNITED HEALTHCARE
DC2037700OtherUNITED HEALTHCARE
DC027447100Medicaid