Healthcare Provider Details

I. General information

NPI: 1629663646
Provider Name (Legal Business Name): JOHN S TROIANI MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2021
Last Update Date: 03/02/2021
Certification Date: 03/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10903 NEW HAMPSHIRE AVE
SILVER SPRING MD
20993-0002
US

IV. Provider business mailing address

7401 WESTLAKE TER APT 316
BETHESDA MD
20817-6565
US

V. Phone/Fax

Practice location:
  • Phone: 301-796-4258
  • Fax:
Mailing address:
  • Phone: 301-633-9991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD84432
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number38077
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: