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General NPI Number Information
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NPI Number | 1053119602
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Entity Type | Organization
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Legal Business Name | MJM ANESTHESIA ,LLC
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Dates
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Enumeration Date | 03/07/2025
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 223 7TH ST NE
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City | WASHINGTON
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State | DC
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Zip | 20002-7045
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Country | US
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Telephone | 202-964-1160
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 235
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City | CABIN JOHN
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State | MD
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Zip | 20818-0235
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Country | US
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Telephone | 202-413-6296
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | DR. HEATHER GAIL DAILEY
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Credential |
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Telephone | 202-964-1160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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