Healthcare Provider Details

I. General information

NPI: 1811058050
Provider Name (Legal Business Name): DR. WILLIAM LAURENCE DAHUT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 GEORGIA AVENUE, NW
WASHINGTON DC
20307-5001
US

IV. Provider business mailing address

309 BECKWITH STREET
GAITHERSBURG MD
20878
US

V. Phone/Fax

Practice location:
  • Phone: 301-435-8183
  • Fax:
Mailing address:
  • Phone: 301-990-8255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberD0036770
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: