Healthcare Provider Details

I. General information

NPI: 1881822641
Provider Name (Legal Business Name): MARC WORDEN HEARING AID SPECIALI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2009
Last Update Date: 06/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7103 DEMOCRACY BLVD
BETHESDA MD
20817-1007
US

IV. Provider business mailing address

6909 SHEPHERD ST
HYATTSVILLE MD
20784-2533
US

V. Phone/Fax

Practice location:
  • Phone: 301-365-6270
  • Fax:
Mailing address:
  • Phone: 301-365-6270
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number02509
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number2101001530
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: