Provider Demographics
NPI:1952440166
Name:DENNIS R WIRT MD PC
Entity Type:Organization
Organization Name:DENNIS R WIRT MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:C
Authorized Official - Last Name:DIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-547-3100
Mailing Address - Street 1:801 PENNSYLVANIA AVE. SE 310
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003
Mailing Address - Country:US
Mailing Address - Phone:202-547-3100
Mailing Address - Fax:202-547-0722
Practice Address - Street 1:801 PENNSYLVANIA AVE. SE 310
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003
Practice Address - Country:US
Practice Address - Phone:202-547-3100
Practice Address - Fax:202-547-0722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
F26789Medicare UPIN