Healthcare Provider Details
I. General information
NPI: 1679887541
Provider Name (Legal Business Name): NATIONAL NAVAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/03/2010
Last Update Date: 08/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8901 WISCONSIN AVE BUILDING 9, 2ND FLOOR, ROOM 2524
BETHESDA MD
20889-0001
US
IV. Provider business mailing address
8901 WISCONSIN AVE BUILDING 9, 2ND FLOOR, ROOM 2524
BETHESDA MD
20889-0001
US
V. Phone/Fax
- Phone: 301-295-4339
- Fax: 301-295-4836
- Phone: 301-295-4339
- Fax: 301-295-4836
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 286500000X |
| Taxonomy | Military Hospital |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
STEVEN
MARC
STOKES
Title or Position: GPR DIRECTOR
Credential: DDS
Phone: 301-295-4339