Organization
EASTON L. MANDERSON, M.D., F.A.C.S., PC
Active
Other names
Manderson Orthopaedic Clinic and Joint Pain Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EASTON L. MANDERSON M.D. (OWNER)
(202) 526-5300
Entity
Organization
Contact information
Practice address
1140 VARNUM ST NE STE 108, WASHINGTON, DC 20017-2152
(202) 526-5300
(202) 526-6013
Mailing address
1140 VARNUM ST NE STE 108, WASHINGTON, DC 20017-2152
(202) 526-5300
(202) 526-6013
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021189900
—
DC
01
—
147572700
DEPT OF LABOR
DC
01
—
4053124
AETNA
—
01
—
60184300
AMERIHEALTH DC MEDICAID
DC
01
—
DE6844
RAILROAD MEDICARE
GA
01
—
F921
CAREFIRST
DC
Enumeration date
07/06/2006
Last updated
04/15/2014
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