| Wisconsin Avenue Psychiatric Center | |
|
4228 Wisconsin Ave Nw Washington DC 20016-2138 | |
| (202) 885-5600 | |
| (202) 966-7374 |
| Full Name | Wisconsin Avenue Psychiatric Center |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 4228 Wisconsin Ave Nw, Washington, District Of Columbia |
| Authorized Official Name and Position | Charles J Baumgardner (VP OF CORPORATE OPERATIONS) |
| Authorized Official Contact | 2028855600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wisconsin Avenue Psychiatric Center 4228 Wisconsin Ave Nw Washington DC 20016-2138 Ph: (202) 885-5600 | Wisconsin Avenue Psychiatric Center 4228 Wisconsin Ave Nw Washington DC 20016-2138 Ph: (202) 885-5600 |
| NPI Number | 1922398734 |
|---|---|
| Provider Enumeration Date | 04/13/2011 |
| Last Update Date | 02/18/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922398734 | NPI | - | NPPES |
| 074500601 | Medicaid | MD | |
| 026402100 | Medicaid | DC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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