Healthcare Provider Details

I. General information

NPI: 1154358851
Provider Name (Legal Business Name): WILLIAM W YOUNG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 07/10/2024
Certification Date: 07/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 WISCONSIN AVE BLDG 19 WALTER REED NATIONAL MILITARY MEDICAL CENTER BETHESDA
BETHESDA MD
20889-5600
US

IV. Provider business mailing address

8901 WISCONSIN AVE BLDG 19 WALTER REED NATIONAL MILITARY MEDICAL CENTER BETHESDA
BETHESDA MD
20889-5600
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-4771
  • Fax: 301-295-4759
Mailing address:
  • Phone: 301-295-4771
  • Fax: 301-295-4759

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101221304
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number0101221304
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: