Provider Demographics
NPI:1659496867
Name:WHITMAN-WALKER CLINIC, INC.
Entity Type:Organization
Organization Name:WHITMAN-WALKER CLINIC, INC.
Other - Org Name:MAX ROBINSON CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF QUALITY IMPROVEMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:HAGER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, MPH
Authorized Official - Phone:202-797-3590
Mailing Address - Street 1:1701 14TH STREET, NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-4308
Mailing Address - Country:US
Mailing Address - Phone:202-745-7000
Mailing Address - Fax:202-797-3504
Practice Address - Street 1:2301 MARTIN LUTHER KING JUNIOR AVENUE, SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-5813
Practice Address - Country:US
Practice Address - Phone:202-745-7000
Practice Address - Fax:202-678-8099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC038947600Medicaid
DC19666OtherCHARTERED HEALTH PLAN
DC022382100Medicaid
DC022382100Medicaid