Healthcare Provider Details

I. General information

NPI: 1891028486
Provider Name (Legal Business Name): BRIAN ALEXANDER DUMMETT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2009
Last Update Date: 12/03/2021
Certification Date: 12/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 E JEFFERSON ST STE 300
ROCKVILLE MD
20852-4908
US

IV. Provider business mailing address

6303 BERKSHIRE DR
BETHESDA MD
20814-2200
US

V. Phone/Fax

Practice location:
  • Phone: 301-816-7405
  • Fax:
Mailing address:
  • Phone: 443-538-7720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD87250
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2083C0008X
TaxonomyClinical Informatics Physician
License Number071871
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: