Provider Demographics
NPI:1548202252
Name:JAMES A D'ORTA MD PC
Entity Type:Organization
Organization Name:JAMES A D'ORTA MD PC
Other - Org Name:MINUTECLINIC DIAGNOSTIC OF WASHINGTON DC PC
Other - Org Type:Other Name
Authorized Official - Title/Position:SENIOR CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-767-1947
Mailing Address - Street 1:333 WASHINGTON AVE N
Mailing Address - Street 2:# 5000
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55401-1377
Mailing Address - Country:US
Mailing Address - Phone:612-659-7111
Mailing Address - Fax:612-659-7101
Practice Address - Street 1:845 BLADENSBURG RD NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-3927
Practice Address - Country:US
Practice Address - Phone:612-659-7111
Practice Address - Fax:612-659-7101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care