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NPI Code Detail

MEDICARE: OLIVIA EASLEY M.D.

MEDICARE: OLIVIA EASLEY M.D.
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
1207R00000XInternal Medicine PhysicianD0058385MD

General Provider Information

NPI Number : 1871864421
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLIVIA EASLEY M.D.
Provider Business Mailing Address
First Line : 9309 OLD GEORGETOWN RD
Second Line :
City : BETHESDA
State : MD
Zip : 20814-1620
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9309 OLD GEORGETOWN RD
Second Line :
City : BETHESDA
State : MD
Zip : 20814-1620
Country : US
Telephone Number : 301-493-2400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2012
Last Update Date : 01/13/2012

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Directions to “ OLIVIA EASLEY M.D.” Practice Location

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