Provider Demographics
NPI:1629073838
Name:ROTHSCHILD, STANLEY R (MD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:R
Last Name:ROTHSCHILD
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 1:3301 NEW MEXICO AVE NW
Mailing Address - Street 2:STE 248
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-3610
Mailing Address - Country:US
Mailing Address - Phone:202-244-0706
Mailing Address - Fax:202-686-6278
Practice Address - Street 1:3301 NEW MEXICO AVE NW
Practice Address - Street 2:STE 248
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-3610
Practice Address - Country:US
Practice Address - Phone:202-244-0706
Practice Address - Fax:202-686-6278
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-15
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD6310207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC145601500OtherACS/ DOL PROVIDER #
DC0220273 00Medicaid
DC493173OtherNCPPO PROVIDER #
DC1506 0002OtherCARE FIRST PROVIDER # DC
DCB94635Medicare UPIN
DC0220273 00Medicaid