Provider Demographics
NPI:1578788899
Name:WHITE FLINT MEDICAL & NATURAL HEALING CENTER
Entity Type:Organization
Organization Name:WHITE FLINT MEDICAL & NATURAL HEALING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:RIFKIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:301-231-0050
Mailing Address - Street 1:6101 EXECUTIVE BLVD
Mailing Address - Street 2:SUITE 280
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3907
Mailing Address - Country:US
Mailing Address - Phone:301-231-0050
Mailing Address - Fax:301-231-6057
Practice Address - Street 1:11119 ROCKVILLE PIKE
Practice Address - Street 2:#209
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3143
Practice Address - Country:US
Practice Address - Phone:301-231-0050
Practice Address - Fax:301-231-6057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01188111N00000X, 111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G00194Medicare UPIN