Organization
CAPITOL MEDICAL CENTER LLC
Active
Other names
d/b/a Capitol Medical Center Group Practice
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN MONTOIS (CHIEF FINANCIAL OFFICER)
(202) 574-6837
Entity
Organization
Contact information
Practice address
1310 SOUTHERN AVE SE, WASHINGTON, DC 20032-4623
(202) 574-6837
(202) 574-7188
Mailing address
1310 SOUTHERN AVE SE, WASHINGTON, DC 20032-4623
(202) 574-6837
(202) 574-7188
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
HFDO10198
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
090008
MEDICARE ACUTE
DC
Enumeration date
07/09/2008
Last updated
05/21/2009
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