Healthcare Provider Details

I. General information

NPI: 1568524619
Provider Name (Legal Business Name): DANIELLE GOODMAN DOOLEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2006
Last Update Date: 06/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3020 14TH ST NW
WASHINGTON DC
20009-6865
US

IV. Provider business mailing address

1220 12TH ST SE SUITE 120
WASHINGTON DC
20003-3722
US

V. Phone/Fax

Practice location:
  • Phone: 202-745-4300
  • Fax:
Mailing address:
  • Phone: 202-715-7900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD034917
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: