=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629172309
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAMES KEVIN MARKWELL M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/12/2006
-----------------------------------------------------
Last Update Date | 11/22/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | NATIONAL NAVAL MED CTR 8901 WISCONSIN AVE OTOLARYNGOLOGY DEPARTMENT
-----------------------------------------------------
City | BETHESDA
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20889-0001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-295-4670
-----------------------------------------------------
Fax | 301-295-6666
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10225 FREDERICK AVE APT. 301
-----------------------------------------------------
City | KENSINGTON
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20895-3308
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-295-4678
-----------------------------------------------------
Fax | 301-295-6666
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Y00000X
-----------------------------------------------------
Taxonomy Name | Otolaryngology Physician
-----------------------------------------------------
License Number | 0101039565
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------