Provider Demographics
NPI:1619083052
Name:JAMIESON, COSETTE O (MD)
Entity Type:Individual
Prefix:DR
First Name:COSETTE
Middle Name:O
Last Name:JAMIESON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 IRVING STREET NW
Mailing Address - Street 2:SUITE 2500 NORTH TOWER
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010
Mailing Address - Country:US
Mailing Address - Phone:202-877-5408
Mailing Address - Fax:202-722-0505
Practice Address - Street 1:106 IRVING STREET NW
Practice Address - Street 2:SUITE 2500 NORTH TOWER
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010
Practice Address - Country:US
Practice Address - Phone:202-877-5408
Practice Address - Fax:202-722-0505
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD19681207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC25654600Medicaid
DC562092Medicare PIN
DC25654600Medicaid