Basic Information
| Provider Information | |||||||||
| NPI: | 1427209444 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HAMPTON | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | MARK | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8926 WOODYARD RD | ||||||||
| Address2: | SUITE 701 | ||||||||
| City: | CLINTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207354220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018561682 | ||||||||
| FaxNumber: | 3018560964 | ||||||||
| Practice Location | |||||||||
| Address1: | 12825 MINNIEVILLE RD | ||||||||
| Address2: | SUITE 203 | ||||||||
| City: | WOODBRIDGE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 221923618 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018561682 | ||||||||
| FaxNumber: | 3018560964 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/08/2008 | ||||||||
| LastUpdateDate: | 02/01/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207XX0005X | 24665 | MA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine | 207XX0005X | 0101251096 | VA | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine | 207XX0005X | D0073464 | MD | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine |
ID Information
| ID | Type | State | Issuer | Description | 977763 | 01 | CAREFIRST MARYLAND | OTHER | 9235671 | 01 | AETNA | OTHER | 4695-0053 | 01 | CAREFIRST DC | OTHER |