Healthcare Provider Details

I. General information

NPI: 1720049539
Provider Name (Legal Business Name): JOHN W. DENOBILE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 10/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NNMC DEPARTMENT OF GENERAL SURGERY 8901 WISCONSIN AVE.
BETHESDA MD
20889-0001
US

IV. Provider business mailing address

NNMC DEPARTMENT OF GENERAL SURGERY 8901 WISCONSIN AVE.
BETHESDA MD
20889-0001
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-4435
  • Fax: 301-295-0959
Mailing address:
  • Phone: 301-295-4435
  • Fax: 301-295-0959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License NumberMD14812
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD14812
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: