Healthcare Provider Details

I. General information

NPI: 1831314897
Provider Name (Legal Business Name): DONALD W. HIRSH D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 10/15/2020
Certification Date: 10/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14440 CHERRY LANE CT SUITE 100
LAUREL MD
20707-4946
US

IV. Provider business mailing address

14440 CHERRY LANE CT SUITE 100
LAUREL MD
20707-4946
US

V. Phone/Fax

Practice location:
  • Phone: 301-490-7785
  • Fax: 301-604-8834
Mailing address:
  • Phone: 301-490-7785
  • Fax: 301-604-8834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberS01385
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code111NR0200X
TaxonomyRadiology Chiropractor
License NumberS01385
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberS01385
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberS01385
License Number StateMD
# 5
Primary TaxonomyN
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License NumberS01385
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: