Healthcare Provider Details

I. General information

NPI: 1558393991
Provider Name (Legal Business Name): SIDNEY ROYE DEBURGH HINDS II M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 06/06/2024
Certification Date: 06/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 OLD GEORGETOWN RD. SUITE 700
BETHESDA MD
20814
US

IV. Provider business mailing address

14933 DUFIEF DR
NORTH POTOMAC MD
20878-2518
US

V. Phone/Fax

Practice location:
  • Phone: 240-997-1081
  • Fax:
Mailing address:
  • Phone: 240-997-1081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207UN0902X
TaxonomyNuclear Imaging & Therapy Physician
License Number0101056711
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number0101056711
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: