Provider Demographics
NPI:1316385156
Name:UPTEGRAFT, COLBY C (MD, MPH, MBI)
Entity type:Individual
Prefix:DR
First Name:COLBY
Middle Name:C
Last Name:UPTEGRAFT
Suffix:
Gender:M
Credentials:MD, MPH, MBI
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7700 ARLINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-2929
Mailing Address - Country:US
Mailing Address - Phone:202-527-9636
Mailing Address - Fax:
Practice Address - Street 1:JOINT BASE ANACOSTIA-BOLLING CLINIC
Practice Address - Street 2:238 BROOKLEY AVE SW, BLDG #1300
Practice Address - City:JOINT BASE ANACOSTIA-BOLLING
Practice Address - State:DC
Practice Address - Zip Code:20032
Practice Address - Country:US
Practice Address - Phone:202-404-5512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-13
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2740722083P0901X, 2083C0008X, 2083A0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083C0008XAllopathic & Osteopathic PhysiciansPreventive MedicineClinical Informatics
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine