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General NPI Number Information
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NPI Number | 1164777983
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Entity Type | Organization
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Legal Business Name | DR D-V
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Dates
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Enumeration Date | 07/18/2012
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Last Update Date | 09/04/2012
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Provider Practice Location Address
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Address Line | 1 E CHASE ST # 810
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City | BALTIMORE
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State | MD
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Zip | 21202-2526
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Country | US
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Telephone | 818-251-6498
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Fax |
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Provider Business Mailing Address
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Address Line | 1 E CHASE ST # 810
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City | BALTIMORE
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State | MD
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Zip | 21202-2577
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Country | US
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Telephone | 818-251-6498
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DUSHYANT VISWANATHAN
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Credential | MD
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Telephone | 818-251-6498
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 1041482
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License Number State | MD
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