Healthcare Provider Details

I. General information

NPI: 1952495806
Provider Name (Legal Business Name): DAVID RICHARD STAGLIANO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 02/22/2023
Certification Date: 02/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 WISCONSIN AVE
BETHESDA MD
20889-5611
US

IV. Provider business mailing address

8091 WISCONSIN AVENUE WALTER REED NATIONAL MILITARY MEDICAL CENTER
BETHESDA MD
20889-5600
US

V. Phone/Fax

Practice location:
  • Phone: 301-400-1622
  • Fax: 301-319-2420
Mailing address:
  • Phone: 301-400-1622
  • Fax: 301-319-2420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101237674
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License Number0101237674
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: