Healthcare Provider Details

I. General information

NPI: 1619506979
Provider Name (Legal Business Name): AASHISH DEWAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2020
Last Update Date: 04/11/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18109 PRINCE PHILIP DR STE B200
OLNEY MD
20832-1591
US

IV. Provider business mailing address

11403 BROOK RUN DR
GERMANTOWN MD
20876-6021
US

V. Phone/Fax

Practice location:
  • Phone: 240-883-9791
  • Fax:
Mailing address:
  • Phone: 301-832-7858
  • 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 Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD600001864
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number156122
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD98444
License Number StateMD
# 5
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101279871
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: