Provider Demographics
NPI:1518136035
Name:EAR,NOSE & THROAT MEDICAL GROUP OF WASHINGTON P.C.
Entity Type:Organization
Organization Name:EAR,NOSE & THROAT MEDICAL GROUP OF WASHINGTON P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:GORDON
Authorized Official - Last Name:VAP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-223-3560
Mailing Address - Street 1:2021 K ST NW
Mailing Address - Street 2:SUITE 210
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20006-1003
Mailing Address - Country:US
Mailing Address - Phone:202-223-3560
Mailing Address - Fax:202-223-3339
Practice Address - Street 1:2021 K ST NW
Practice Address - Street 2:SUITE 210
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-1003
Practice Address - Country:US
Practice Address - Phone:202-223-3560
Practice Address - Fax:202-223-3339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-28
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD3439207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC3700OtherCAREFIRST BLUECROSS BLUE SHIELD
DC001037OtherANTHEM BLUECROSS BLUESHIELD
DC=========OtherCIGNA HEALTH INSURANCE
DC=========OtherTRICARE HEALTH INSURANCE
DC001037OtherANTHEM BLUECROSS BLUESHIELD
DC=========OtherCORESOURCE INSURANCE
DC3700OtherCAREFIRST BLUECROSS BLUE SHIELD
DC=========OtherALLIANCE ONENET INSURANCE
DC=========OtherNCAS HEALTH INSURANCE
DC=========OtherAARP UNITED HEALTHCARE INS CO
DC=========OtherAETNA HEALTH INSURANCE
DC=========OtherGEHA HEALTH INSURANCE
DC=========OtherOPTIMUM CHOICE HEALTH INSURANCE
DC=========OtherHEALTHLINK NCPPO INSURANCE
DC=========OtherGUARDIAN HEALTH INSURANCE
DC=========OtherASSOCIATION & SOCIETY HEALTH INSURANCE
DC=========OtherASURANT HEALTH INSURANCE
DC=========OtherASURANT HEALTH INSURANCE