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General NPI Number Information
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NPI Number | 1639334865
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Entity Type | Organization
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Legal Business Name | BETHESDA ALLERGY & ASTHMA CLINIC, LLC
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Dates
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Enumeration Date | 07/28/2008
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Last Update Date | 04/29/2009
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Provider Practice Location Address
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Address Line | 10401 OLD GEORGETOWN RD SUITE #407
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City | BETHESDA
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State | MD
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Zip | 20814-1911
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Country | US
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Telephone | 301-564-4090
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Fax |
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Provider Business Mailing Address
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Address Line | 10401 OLD GEORGETOWN RD SUITE #407
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City | BETHESDA
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State | MD
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Zip | 20814-1911
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Country | US
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Telephone | 301-564-4090
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | JOHN S. IRONS
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Credential | M.D.
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Telephone | 301-564-4090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number |
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License Number State |
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