Healthcare Provider Details

I. General information

NPI: 1902876832
Provider Name (Legal Business Name): HUGH MICHAEL DAINER MD, PHD, MBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 04/01/2024
Certification Date: 04/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 WISCONSIN AVE
BETHESDA MD
20889
US

IV. Provider business mailing address

WALTER REED NATIONAL MILITARY MEDICAL CENTER 8901 ROCKVILLE PIKE - DEPT OF RADIOLOGY
BETHESDA MD
20889-0001
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-5050
  • Fax:
Mailing address:
  • Phone: 301-295-5050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License NumberD0060641
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberD0060641
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License NumberD0060641
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberD0060641
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: