Provider Demographics
NPI: | 1417990581 |
---|---|
Name: | MEDICAL FACULTY ASSOCIATES, INC |
Entity type: | Organization |
Organization Name: | MEDICAL FACULTY ASSOCIATES, INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CHIEF EXECUTIVE OFFICER |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | STEPHEN |
Authorized Official - Middle Name: | L |
Authorized Official - Last Name: | BADGER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 202-741-3350 |
Mailing Address - Street 1: | 2150 PENNSYLVANIA AVE NW |
Mailing Address - Street 2: | SUITE 10-409A |
Mailing Address - City: | WASHINGTON |
Mailing Address - State: | DC |
Mailing Address - Zip Code: | 20037-3201 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 202-741-3350 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 2150 PENNSYLVANIA AVE NW |
Practice Address - Street 2: | SUITE 10-409A |
Practice Address - City: | WASHINGTON |
Practice Address - State: | DC |
Practice Address - Zip Code: | 20037-3201 |
Practice Address - Country: | US |
Practice Address - Phone: | 202-741-3350 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-06-14 |
Last Update Date: | 2008-01-28 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology | Group - Multi-Specialty | |
No | 207N00000X | Allopathic & Osteopathic Physicians | Dermatology | Group - Multi-Specialty | |
No | 207ND0900X | Allopathic & Osteopathic Physicians | Dermatology | Dermatopathology | Group - Multi-Specialty |
No | 207P00000X | Allopathic & Osteopathic Physicians | Emergency Medicine | Group - Multi-Specialty | |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 207SG0202X | Allopathic & Osteopathic Physicians | Medical Genetics | Clinical Biochemical Genetics | Group - Multi-Specialty |
No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
No | 207W00000X | Allopathic & Osteopathic Physicians | Ophthalmology | Group - Multi-Specialty | |
No | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
No | 207Y00000X | Allopathic & Osteopathic Physicians | Otolaryngology | Group - Multi-Specialty | |
No | 207ZB0001X | Allopathic & Osteopathic Physicians | Pathology | Blood Banking & Transfusion Medicine | Group - Multi-Specialty |
No | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Multi-Specialty | |
No | 208200000X | Allopathic & Osteopathic Physicians | Plastic Surgery | Group - Multi-Specialty | |
No | 2085B0100X | Allopathic & Osteopathic Physicians | Radiology | Body Imaging | Group - Multi-Specialty |
No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
DC | G00383 | Medicare ID - Type Unspecified |