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General NPI Number Information
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NPI Number | 1699816363
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Entity Type | Organization
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Legal Business Name | WASHINGTON CENTER FOR DIABETES AND ENDOCRINOLOGY,LLC.
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 06/23/2010
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Provider Practice Location Address
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Address Line | 6320 DEMOCRACY BLVD
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City | BETHESDA
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State | MD
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Zip | 20817-1664
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Country | US
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Telephone | 301-564-6003
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Fax | 301-564-5202
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Provider Business Mailing Address
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Address Line | PO BOX 341644
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City | W BETHESDA
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State | MD
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Zip | 20827-1644
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Country | US
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Telephone | 301-564-6003
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Fax | 301-564-5202
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DR. GAWIN L FLYNN
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Credential | M.D.
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Telephone | 301-564-6003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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