Healthcare Provider Details

I. General information

NPI: 1356317069
Provider Name (Legal Business Name): NATIONAL NAVAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PROFESSIONAL AFFAIRS 8901 WISCONSIN AVE
BETHESDA MD
20889-0001
US

IV. Provider business mailing address

3716 FERRARA DR
SILVER SPRING MD
20906-4762
US

V. Phone/Fax

Practice location:
  • Phone: 301-319-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code286500000X
TaxonomyMilitary Hospital
License Number
License Number StateVA

VIII. Authorized Official

Name: DR. JOCELYN KEHINDE AJALA
Title or Position: RESIDENT
Credential: MD
Phone: 301-319-5000