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Organization

WISCONSIN AVENUE PSYCHIATRIC CENTER

Active
Other names
Psychiatric Institute of Washington
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CHARLES J BAUMGARDNER (VP OF CORPORATE OPERATIONS)
(202) 885-5600
Entity
Organization

Contact information

Practice address
4228 WISCONSIN AVE NW, WASHINGTON, DC 20016-2138
(202) 885-5600
(202) 966-7374
Mailing address
4228 WISCONSIN AVE NW, WASHINGTON, DC 20016-2138
(202) 885-5600
(202) 966-7374

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
026402100
DC
05
074500601
MD
Enumeration date
04/13/2011
Last updated
02/18/2014
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