Healthcare Provider Details

I. General information

NPI: 1497282297
Provider Name (Legal Business Name): WILLIAM EDWARD RALLYA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 07/14/2024
Certification Date: 07/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 WISCONSIN AVE. TRANSITIONAL PRGM WRNMMC
BETHESDA MD
20889
US

IV. Provider business mailing address

8901 WISCONSIN AVE ANESTHESIOLOGY DEPT
BETHESDA MD
20889-0001
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-9283
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number0101265206
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD500002929
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: