Basic Information
| Provider Information | |||||||||
| NPI: | 1669700399 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DANIEL HEXTER MD PA | ||||||||
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| OtherOrganizationName: | ANNAPOLIS NEUROLOGY ASSOCIATES | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 122 DEFENSE HWY | ||||||||
| Address2: | |||||||||
| City: | ANNAPOLIS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 214017069 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4434816467 | ||||||||
| FaxNumber: | 4434816515 | ||||||||
| Practice Location | |||||||||
| Address1: | 130 LOVE POINT RD | ||||||||
| Address2: | SUITE 107 | ||||||||
| City: | STEVENSVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 216662132 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4102669694 | ||||||||
| FaxNumber: | 4102669695 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/18/2009 | ||||||||
| LastUpdateDate: | 11/13/2013 | ||||||||
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| AuthorizedOfficialLastName: | HEXTER | ||||||||
| AuthorizedOfficialFirstName: | DANIEL | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4102669694 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
ID Information
| ID | Type | State | Issuer | Description | 418967801 | 05 | MD | MEDICAID |