Provider Demographics
NPI: | 1932235991 |
---|---|
Name: | GREATER WASHINGTON MATERNAL FETAL MEDICINE AND GENETICS |
Entity type: | Organization |
Organization Name: | GREATER WASHINGTON MATERNAL FETAL MEDICINE AND GENETICS |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | THOMAS |
Authorized Official - Middle Name: | L |
Authorized Official - Last Name: | PINCKERT |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 301-279-6355 |
Mailing Address - Street 1: | 9707 MEDICAL CENTER DR |
Mailing Address - Street 2: | SUITE 230 |
Mailing Address - City: | ROCKVILLE |
Mailing Address - State: | MD |
Mailing Address - Zip Code: | 20850-3348 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 310-279-6355 |
Mailing Address - Fax: | 240-499-3279 |
Practice Address - Street 1: | 9707 MEDICAL CENTER DR |
Practice Address - Street 2: | SUITE 230 |
Practice Address - City: | ROCKVILLE |
Practice Address - State: | MD |
Practice Address - Zip Code: | 20850-3348 |
Practice Address - Country: | US |
Practice Address - Phone: | 310-279-6355 |
Practice Address - Fax: | 240-499-3279 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-02-26 |
Last Update Date: | 2011-04-29 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center |