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Organization
PHS ORTHOPAEDICS ROCKVILLE
Active
Organization
PHS ORTHOPAEDICS ROCKVILLE
Active
Parent organization
PROVIDENCE HOSPITAL
Other names
Providence Health Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE HOSPITAL
Authorized official
MR. CHARLES F HABERKERN (VP)
(202) 854-4255
Entity
Organization
Contact information
Practice address
9707 MEDICAL CENTER DR, SUITE 310, ROCKVILLE, MD 20850-3348
(301) 315-6380
(301) 315-6382
Mailing address
1160 VARNUM ST NE, ST CATHERINE'S HALL, ROOM 102, WASHINGTON, DC 20017-2107
(202) 854-4069
(202) 854-7825
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
HFD01-0212
DC
282N00000X
General Acute Care Hospital
HFD01-0212
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005145400
—
MD
05
—
029833400
—
DC
05
—
09810714
—
VA
Enumeration date
12/14/2011
Last updated
09/06/2016
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