MEDICARE: DR. KARL DEREK HAWVER 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	2084P0800X	Psychiatry Physician	D0005016	MD

General Provider Information

NPI Number	:	1437152758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KARL DEREK HAWVER M.D.

Provider Business Mailing Address
First Line	:	4213 SAUL RD
Second Line	:
City	:	KENSINGTON
State	:	MD
Zip	:	20895-3728
Country	:	US
Telephone Number	:	301-933-8321
Fax Number	:	301-933-5075

Provider Business Practice Location Address
First Line	:	4213 SAUL RD
Second Line	:
City	:	KENSINGTON
State	:	MD
Zip	:	20895-3728
Country	:	US
Telephone Number	:	301-933-8321
Fax Number	:	301-933-5075

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

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	07/08/2007

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