Provider Demographics
NPI:1760792956
Name:NATIONAL CANCER INSTITUTE
Entity Type:Organization
Organization Name:NATIONAL CANCER INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR INVESTIGATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIGITTE
Authorized Official - Middle Name:CHARLOTTE
Authorized Official - Last Name:WIDEMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-496-7387
Mailing Address - Street 1:10 CENTER DRIVE, BUILDING 10, CRC
Mailing Address - Street 2:ROOM 1-5750
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20892-1101
Mailing Address - Country:US
Mailing Address - Phone:301-496-7387
Mailing Address - Fax:
Practice Address - Street 1:10 CENTER DRIVE, BUILDING 10, ROOM 1-5750
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-1101
Practice Address - Country:US
Practice Address - Phone:301-496-7387
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-21
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0054838251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare