Provider Demographics
NPI:1780672022
Name:GYFTOPOULOS, ANASTASIA T (MD)
Entity Type:Individual
Prefix:
First Name:ANASTASIA
Middle Name:T
Last Name:GYFTOPOULOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 VARNUM ST NE
Mailing Address - Street 2:STE 040
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-2151
Mailing Address - Country:US
Mailing Address - Phone:202-529-3577
Mailing Address - Fax:202-635-7432
Practice Address - Street 1:1140 VARNUM ST NE
Practice Address - Street 2:STE 040
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-2151
Practice Address - Country:US
Practice Address - Phone:202-529-3577
Practice Address - Fax:202-635-7432
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-11
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC418166Medicare PIN
B94805Medicare UPIN