MEDICARE: MR. DANIEL RAYMOND DRIVER RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835N0905X	Nuclear Pharmacist	09552	MD

General Provider Information

NPI Number	:	1427022847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DANIEL RAYMOND DRIVER RPH

Provider Business Mailing Address
First Line	:	10307 DICKENS AVE
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20814-2131
Country	:	US
Telephone Number	:	301-530-8790
Fax Number	:	301-564-9654

Provider Business Practice Location Address
First Line	:	8901 WISCONSIN AVE
Second Line	:	BUILDING 9, ROOM 0804, NUCLEAR MEDICINE
City	:	BETHESDA
State	:	MD
Zip	:	20889-0001
Country	:	US
Telephone Number	:	301-295-4985
Fax Number	:	301-295-2649

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2006
Last Update Date	:	07/08/2007

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