Organization
GW THE MEDICAL FACULTY ASSOCIATE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROGER MAGBOO BRUCAL AGPCNP-BC (NURSE PRACTITIONER)
(240) 481-3356
Entity
Organization
Contact information
Practice address
2150 PENNSYLVANIA AVE NW, DEPARTMENT OF SURGERY, SUITE 6B-412, WASHINGTON, DC 20037-3201
(202) 741-3225
Mailing address
10401 GROSVENOR PL, APT 1311, ROCKVILLE, MD 20852-4646
(240) 481-3356
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN1004515
DC
Other
Enumeration date
06/18/2015
Last updated
06/18/2015
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