Provider Demographics
NPI:1184727349
Name:DAVID DREW CLINIC INC.
Entity type:Organization
Organization Name:DAVID DREW CLINIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:SONCRANT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-656-1262
Mailing Address - Street 1:5454 WISCONSIN AVE
Mailing Address - Street 2:STE 1410
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-6901
Mailing Address - Country:US
Mailing Address - Phone:301-656-1262
Mailing Address - Fax:301-656-3238
Practice Address - Street 1:5454 WISCONSIN AVE
Practice Address - Street 2:STE 1410
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-6901
Practice Address - Country:US
Practice Address - Phone:301-656-1262
Practice Address - Fax:301-656-3238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty