Healthcare Provider Details

I. General information

NPI: 1487851853
Provider Name (Legal Business Name): NATHANAEL S DAYES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 12/16/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 HOSPITAL DR
CHEVERLY MD
20785-1189
US

IV. Provider business mailing address

29 S GREENE ST STE 319
BALTIMORE MD
21201-1504
US

V. Phone/Fax

Practice location:
  • Phone: 667-214-1718
  • Fax: 410-328-5147
Mailing address:
  • Phone: 667-214-1718
  • Fax: 410-328-5147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number0101254762
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number255105
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberD73653
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: