Provider Demographics
NPI:1548580822
Name:MENDEZ-ESCOBAR, IVAN (MD)
Entity Type:Individual
Prefix:
First Name:IVAN
Middle Name:
Last Name:MENDEZ-ESCOBAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 IRVING ST NW
Mailing Address - Street 2:DEPARTMENT OF PULMONARY DISEASE / CRITICAL CARE MEDICIN
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-3017
Mailing Address - Country:US
Mailing Address - Phone:202-877-7856
Mailing Address - Fax:202-877-6130
Practice Address - Street 1:110 IRVING ST NW
Practice Address - Street 2:DEPARTMENT OF PULMONARY DISEASE / CRITICAL CARE MEDICIN
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-3017
Practice Address - Country:US
Practice Address - Phone:202-877-7856
Practice Address - Fax:202-877-6130
Is Sole Proprietor?:No
Enumeration Date:2010-06-09
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program