Provider Demographics
NPI:1770512758
Name:METRO MEDICAL ASSOCIATES,INC
Entity Type:Organization
Organization Name:METRO MEDICAL ASSOCIATES,INC
Other - Org Name:METRO MEDICAL ASSOCIATES,INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-442-8889
Mailing Address - Street 1:1612 GRACE CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-1508
Mailing Address - Country:US
Mailing Address - Phone:301-587-4585
Mailing Address - Fax:301-585-4564
Practice Address - Street 1:7603 GEORGIA AVE NW
Practice Address - Street 2:SUITE 304
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-1617
Practice Address - Country:US
Practice Address - Phone:202-726-5014
Practice Address - Fax:202-882-8209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD14127207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCMD14127OtherDC LICENSE
C49181Medicare UPIN