Basic Information
| Provider Information | |||||||||
| NPI: | 1326163544 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WALTER REED NATIONAL MILITARY MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8901 ROCKVILLE PIKE | ||||||||
| Address2: | |||||||||
| City: | BETHESDA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208890001 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 8901 ROCKVILLE PIKE | ||||||||
| Address2: | |||||||||
| City: | BETHESDA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208890001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3012954455 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/20/2007 | ||||||||
| LastUpdateDate: | 03/12/2013 | ||||||||
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| AuthorizedOfficialLastName: | BERRY | ||||||||
| AuthorizedOfficialFirstName: | KYLE | ||||||||
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| AuthorizedOfficialTitleorPosition: | DEPT HEAD | ||||||||
| AuthorizedOfficialTelephone: | 3012954455 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 286500000X | 23960 | NE | Y | Hospitals | Military Hospital |
No ID Information.