Healthcare Provider Details

I. General information

NPI: 1437134590
Provider Name (Legal Business Name): DAVID I MAGILNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 02/22/2021
Certification Date: 02/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MICHIGAN AVE NW
WASHINGTON DC
20010
US

IV. Provider business mailing address

111 MICHIGAN AVE NW
WASHINGTON DC
20010-2916
US

V. Phone/Fax

Practice location:
  • Phone: 202-476-5000
  • Fax: 336-716-5438
Mailing address:
  • Phone: 202-476-5000
  • Fax: 336-716-5438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License Number200301491
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: