Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Phs Ctr for Geriatric Medicine Dp021

Organization Geriatric Medicine (Internal Medicine) Physician · NPI 1538437926

Phs Ctr for Geriatric Medicine Dp021 is a Geriatric Medicine (Internal Medicine) Physician in Washington, District of Columbia. Licensed in District of Columbia. Registered with an NPI since 2011.

Licensed in
DC
In the registry since
2011
Specialties on file
2
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Practice location Address checks out

1160 Varnum St NE Depaul 021
Washington, DC 20017-2107
Phone: (202) 854-7785
Fax: (202) 854-7734
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Geriatric Medicine (Internal Medicine) Physician (primary) Taxonomy 207RG0300X · Licence HFD01-0212 (DC)
General Acute Care Hospital Taxonomy 282N00000X · Licence HFD01-0212 (DC)

Record details

NPI number1538437926
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationProvidence Hospital
Authorized official Charles Haberkern — Vp · (202) 854-4255
Other names Providence Health Services
NPI enumeratedDecember 13, 2011
Last updated in NPPESSeptember 6, 2016
Mailing address1160 Varnum St Ne, St Catherine'S Hall, Room 102, Washington, DC 20017-2107

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