Provider Demographics
NPI:1205944428
Name:ARMSTRONG, EARL MAGNUS (MD)
Entity type:Individual
Prefix:
First Name:EARL
Middle Name:MAGNUS
Last Name:ARMSTRONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1160 VARNUM ST NE
Mailing Address - Street 2:#214
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017
Mailing Address - Country:US
Mailing Address - Phone:202-526-5491
Mailing Address - Fax:202-526-5434
Practice Address - Street 1:1160 VARNUM ST NE
Practice Address - Street 2:#214
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017
Practice Address - Country:US
Practice Address - Phone:202-526-5491
Practice Address - Fax:202-526-5434
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD19993207RP1001X
DCMD11217207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC010274200Medicaid
AA163921Medicare ID - Type Unspecified
DC010274200Medicaid