Healthcare Provider Details

I. General information

NPI: 1053119602
Provider Name (Legal Business Name): MJM ANESTHESIA ,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2025
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 7TH ST NE
WASHINGTON DC
20002-7045
US

IV. Provider business mailing address

PO BOX 235
CABIN JOHN MD
20818-0235
US

V. Phone/Fax

Practice location:
  • Phone: 202-964-1160
  • Fax:
Mailing address:
  • Phone: 202-413-6296
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: DR. HEATHER GAIL DAILEY
Title or Position: OWNER/CEO
Credential:
Phone: 202-964-1160