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General NPI Number Information
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NPI Number | 1407931496
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Entity Type | Individual
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Provider Name | WILLIAM BARA-JIMENEZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 06/11/2008
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Provider Practice Location Address
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Address Line | 10901 CONNECTICUT AVE SUITE 100
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City | KENSINGTON
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State | MD
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Zip | 20895-1645
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Country | US
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Telephone | 240-221-8052
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Fax | 240-221-8054
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Provider Business Mailing Address
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Address Line | 11119 ROCKVILLE PIKE SUITE 100
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City | ROCKVILLE
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State | MD
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Zip | 20852-3143
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Country | US
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Telephone | 301-816-9000
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Fax | 301-816-0295
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | D0052154
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License Number State | MD
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