Healthcare Provider Details

I. General information

NPI: 1710984976
Provider Name (Legal Business Name): HILARY LIGHT-DEUTSCH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2005
Last Update Date: 01/17/2022
Certification Date: 01/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11325 SEVEN LOCKS RD SUITE 238
POTOMAC MD
20854-3205
US

IV. Provider business mailing address

11325 SEVEN LOCKS RD SUITE 238
POTOMAC MD
20854-3205
US

V. Phone/Fax

Practice location:
  • Phone: 301-299-8930
  • Fax: 301-299-8933
Mailing address:
  • Phone: 301-299-8930
  • Fax: 301-299-8933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0046035
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD20725
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: