MEDICARE: DR. DANA MARIE BLYTH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	0101248962	VA
2	207RI0200X	Infectious Disease Physician	0101248962	VA

General Provider Information

NPI Number	:	1114154879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANA MARIE BLYTH M.D.

Provider Business Mailing Address
First Line	:	WRNMMC 8960 BROWN DR
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20889-6200
Country	:	US
Telephone Number	:	301-295-6400
Fax Number	:

Provider Business Practice Location Address
First Line	:	WRNMMC 8960 BROWN DR
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20889-6200
Country	:	US
Telephone Number	:	301-295-6400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2009
Last Update Date	:	02/11/2022

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