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General NPI Number Information
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NPI Number | 1689001547
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Entity Type | Organization
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Legal Business Name | UNIFORMED SERVICES UNIVERSITY OF THE HEALTH SCIENCES
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Dates
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Enumeration Date | 10/08/2013
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Last Update Date | 10/08/2013
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Provider Practice Location Address
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Address Line | 4301 JONES BRIDGE RD
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City | BETHESDA
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State | MD
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Zip | 20814-4712
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Country | US
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Telephone | 301-295-1764
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Fax |
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Provider Business Mailing Address
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Address Line | 4301 JONES BRIDGE RD
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City | BETHESDA
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State | MD
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Zip | 20814-4712
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | DANIEL BLAZ
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Credential |
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Telephone | 301-295-1764
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2865M2000X
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Taxonomy Name | Military General Acute Care Hospital
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License Number | 210913
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License Number State | NC
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