Healthcare Provider Details

I. General information

NPI: 1184678856
Provider Name (Legal Business Name): DANIEL HWANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 05/10/2021
Certification Date: 05/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1860 TOWN CENTER DR SUITE 335
RESTON VA
20190-5896
US

IV. Provider business mailing address

1860 TOWN CENTER DR SUITE 335
RESTON VA
20190-5896
US

V. Phone/Fax

Practice location:
  • Phone: 703-787-3322
  • Fax: 703-787-3380
Mailing address:
  • Phone: 703-787-3322
  • Fax: 703-787-3380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number0101230426
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207YX0602X
TaxonomyOtolaryngic Allergy Physician
License Number0101230426
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: