Healthcare Provider Details

I. General information

NPI: 1639101553
Provider Name (Legal Business Name): WALTER BLAND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 04/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 COLLEGE ST NW
WASHINGTON DC
20059-0001
US

IV. Provider business mailing address

2041 GEORGIA AVE NW STE 6101
WASHINGTON DC
20060-0001
US

V. Phone/Fax

Practice location:
  • Phone: 202-806-7981
  • Fax: 202-806-4083
Mailing address:
  • Phone: 202-595-3223
  • Fax: 202-332-2985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberMD13142
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: