Provider Demographics
NPI:1396749677
Name:DIMAYUGA, FELIPE M
Entity type:Individual
Prefix:DR
First Name:FELIPE
Middle Name:M
Last Name:DIMAYUGA
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:FELIPE
Other - Middle Name:M
Other - Last Name:DIMAYUGA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:5800 GOUCHER DR
Mailing Address - Street 2:
Mailing Address - City:BERWYN HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20740-2625
Mailing Address - Country:US
Mailing Address - Phone:202-767-7300
Mailing Address - Fax:202-404-8154
Practice Address - Street 1:455 OVERLOOK AVE,SW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20375-0001
Practice Address - Country:US
Practice Address - Phone:202-767-7300
Practice Address - Fax:202-404-8154
Is Sole Proprietor?:No
Enumeration Date:2005-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD138742083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine