Provider Demographics
NPI:1376603514
Name:U.S. DEPARTMENT OF STATE
Entity Type:Organization
Organization Name:U.S. DEPARTMENT OF STATE
Other - Org Name:OFFICE OF MEDICAL SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR, QUALITY IMPROVEMENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:G
Authorized Official - Last Name:BURNEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-663-2453
Mailing Address - Street 1:2401 E STREET NW
Mailing Address - Street 2:M.MED.QI, SA-1
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20522-0102
Mailing Address - Country:US
Mailing Address - Phone:202-663-2453
Mailing Address - Fax:202-663-3247
Practice Address - Street 1:2401 E STREET NW
Practice Address - Street 2:M.MED.QI, SA-1
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20522-0102
Practice Address - Country:US
Practice Address - Phone:202-663-2453
Practice Address - Fax:202-663-3247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service