Provider Demographics
NPI:1124319116
Name:POTOMAC INTERNISTS, P.C.
Entity type:Organization
Organization Name:POTOMAC INTERNISTS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:G
Authorized Official - Last Name:NEALON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-237-2910
Mailing Address - Street 1:5215 LOUGHBORO RD NW
Mailing Address - Street 2:SUITE 440
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-2618
Mailing Address - Country:US
Mailing Address - Phone:202-237-2910
Mailing Address - Fax:202-237-2913
Practice Address - Street 1:5215 LOUGHBORO RD NW
Practice Address - Street 2:SUITE 440
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-2618
Practice Address - Country:US
Practice Address - Phone:202-237-2910
Practice Address - Fax:202-237-2913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-25
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC1124319116OtherNPI
B93943Medicare UPIN