Provider Demographics
NPI:1760569271
Name:POURRAT, MONICA DEL CARMEN (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:DEL CARMEN
Last Name:POURRAT
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12505 EXCHANGE CT S
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-2431
Mailing Address - Country:US
Mailing Address - Phone:301-251-5230
Mailing Address - Fax:
Practice Address - Street 1:50 W EDMONSTON DR
Practice Address - Street 2:SUITE 502
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1228
Practice Address - Country:US
Practice Address - Phone:301-637-3005
Practice Address - Fax:866-890-7221
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0062518208000000X
DCMD034920208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC10234246Medicaid
MD41290901Medicaid