Provider Demographics
NPI:1407968829
Name:DOUKAS, MICHAEL ARISTIDES (MD, MPA)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ARISTIDES
Last Name:DOUKAS
Suffix:
Gender:M
Credentials:MD, MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 VERMONT AVE NW
Mailing Address - Street 2:RM 664
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20420-0001
Mailing Address - Country:US
Mailing Address - Phone:202-461-7163
Mailing Address - Fax:202-495-5437
Practice Address - Street 1:810 VERMONT AVE NW
Practice Address - Street 2:RM 664
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20420-0001
Practice Address - Country:US
Practice Address - Phone:202-461-7163
Practice Address - Fax:202-495-5437
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000048778207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN