Provider Demographics
NPI:1912168238
Name:AUGUSTUS, TODD MATTHEW (MD)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:MATTHEW
Last Name:AUGUSTUS
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 1:35 K. STREET NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002
Mailing Address - Country:US
Mailing Address - Phone:202-442-4202
Mailing Address - Fax:202-727-0857
Practice Address - Street 1:35 K ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-4216
Practice Address - Country:US
Practice Address - Phone:202-442-4202
Practice Address - Fax:202-727-0857
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-19
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012535892084P0800X
DCMD0423592084P0800X
MDD720212084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry