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NPI Code Detail

MEDICARE: DR. EDDIE EMANUEL NANCE MD

MEDICARE: DR. EDDIE EMANUEL NANCE MD
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
1207Q00000XFamily Medicine Physician83353SC
2207Q00000XFamily Medicine Physician0101263150VA

General Provider Information

NPI Number : 1881057032
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EDDIE EMANUEL NANCE MD
Provider Business Mailing Address
First Line : 4141 W WILSON RD BLDG 1600
Second Line :
City : INDIAN HEAD
State : MD
Zip : 20640-5162
Country : US
Telephone Number : 301-744-4604
Fax Number : 301-744-4361
Provider Business Practice Location Address
First Line : 4141 W WILSON RD BLDG 1600
Second Line :
City : INDIAN HEAD
State : MD
Zip : 20640-5162
Country : US
Telephone Number : 301-744-4602
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2016
Last Update Date : 06/01/2026

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