Healthcare Provider Details

I. General information

NPI: 1134265523
Provider Name (Legal Business Name): NATIONAL INSTITUTES OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CENTER DRIVE BLDG. 10 CRC, ROOM 3-3288
BETHESDA MD
20892-2089
US

IV. Provider business mailing address

10 CENTER DRIVE BLDG. 10 CRC, ROOM 3-3288
BETHESDA MD
20892-2089
US

V. Phone/Fax

Practice location:
  • Phone: 301-435-3547
  • Fax: 301-480-4354
Mailing address:
  • Phone: 301-435-3547
  • Fax: 301-480-4354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code284300000X
TaxonomySpecial Hospital
License NumberD0060633
License Number StateMD

VIII. Authorized Official

Name: DR. ALAN WAYNE
Title or Position: CLINICAL DIRECTOR
Credential: M.D.
Phone: 301-496-4256