Provider Demographics
NPI:1396717088
Name:MACRI, CHARLES JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:JOHN
Last Name:MACRI
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 1:2150 PENNSYLVANIA AVE NW
Mailing Address - Street 2:STE 10-409A
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037
Mailing Address - Country:US
Mailing Address - Phone:202-741-3398
Mailing Address - Fax:202-741-3396
Practice Address - Street 1:2150 PENNSYLVANIA AVE NW
Practice Address - Street 2:STE 10-409A
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037
Practice Address - Country:US
Practice Address - Phone:202-741-3398
Practice Address - Fax:202-741-3396
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD32181207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD400391800Medicaid
VA006216943Medicaid
DC032356500Medicaid
DC010662M83Medicare ID - Type Unspecified
MD400391800Medicaid