Healthcare Provider Details

I. General information

NPI: 1356547103
Provider Name (Legal Business Name): JOHN D HUNSAKER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2007
Last Update Date: 05/10/2024
Certification Date: 05/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 E ST NW SUITE 201, SA-1 COLUMBIA PLAZA
WASHINGTON DC
20522-0102
US

IV. Provider business mailing address

2401 E ST NW SUITE 201, SA-1 COLUMBIA PLAZA
WASHINGTON DC
20522-0102
US

V. Phone/Fax

Practice location:
  • Phone: 202-663-1692
  • Fax:
Mailing address:
  • Phone: 202-663-1692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number0101275277
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101275277
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: