Provider Demographics
NPI:1285833269
Name:MGMC LLC
Entity Type:Organization
Organization Name:MGMC LLC
Other - Org Name:MEDSTAR GEORGETOWN MEDICAL CANTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-444-7690
Mailing Address - Street 1:2115 WISCONSIN AVE NW
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-2265
Mailing Address - Country:US
Mailing Address - Phone:202-444-1400
Mailing Address - Fax:202-444-7993
Practice Address - Street 1:3800 RESERVOIR RD NW
Practice Address - Street 2:DEPARTMENT OF RADIOLOGY
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-2113
Practice Address - Country:US
Practice Address - Phone:202-444-1400
Practice Address - Fax:202-444-7993
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MGMC LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-11
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty