PHS MEDICAL SPECIALISTS PMB107 NPI 1457693012

NPI Information

NPI: 1457693012
Provider Name: PHS MEDICAL SPECIALISTS PMB107

Other Name: PROVIDENCE HEALTH SERVICES

Classification: Internal Medicine - 207RI0200X
Entity Type: Organization

Specialization: Infectious Disease

Address:
1140 VARNUM ST NE
PMB107
WASHINGTON, DC
ZIP 20017
Phone: (202) 854-4052
Get Directions

PHS MEDICAL SPECIALISTS PMB107 is an infectious disease internal medicine in Washington, DC. The provider is an internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine. PHS MEDICAL SPECIALISTS PMB107 NPI is 1457693012. The provider is registered as an organization entity type.
The provider Other Name Is Providence Health Services.

The provider's business location address is:

1140 VARNUM ST NE
PMB107
WASHINGTON, DC
ZIP 20017-151
Phone: (202) 854-4052
Fax: (202) 854-4832

The provider's authorized official is Charles F Haberkern .
The authorized official title is Vp and has the following contact phone number (202) 854-4255.

The enumeration date for this NPI number is 3/21/2013 and was last updated on 9/6/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	282N00000X	General Acute Care Hospital		HFD01-0212	DISTRICT OF COLUMBIA	No
2	207RI0200X	Internal Medicine	Infectious Disease	HFD01-0212	DISTRICT OF COLUMBIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	09810714	MEDICAID	VIRGINIA
2	005145400	MEDICAID	MARYLAND
3	090006	MEDICARE PIN
4	029833400	MEDICAID	DISTRICT OF COLUMBIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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