Provider Demographics
NPI:1801069679
Name:WYCHE, ROQUELL E (MD)
Entity type:Individual
Prefix:DR
First Name:ROQUELL
Middle Name:E
Last Name:WYCHE
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 1:1015 I ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-3747
Mailing Address - Country:US
Mailing Address - Phone:202-812-4933
Mailing Address - Fax:
Practice Address - Street 1:1015 I ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-3747
Practice Address - Country:US
Practice Address - Phone:202-812-4933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-11
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101281521207RC0000X
MDD68161207RC0000X
DCMD 33157207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease