Healthcare Provider Details

I. General information

NPI: 1043316094
Provider Name (Legal Business Name): DAVID MARC BAND M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20905 PROFESSIONAL PLZ SUITE 220
ASHBURN VA
20147-7783
US

IV. Provider business mailing address

7101 SYCAMORE AVE
TAKOMA PARK MD
20912-4634
US

V. Phone/Fax

Practice location:
  • Phone: 703-858-9841
  • Fax: 703-858-9446
Mailing address:
  • Phone: 301-412-8432
  • Fax: 703-858-9446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101036149
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD0050424
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberC89207565
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: