Basic Information
| Provider Information | |||||||||
| NPI: | 1861686420 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DANIEL HEXTER MD PA | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | ANNAPOLIS NEUROLOGY ASSOCIATES | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 122 DEFENSE HWY | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | ANNAPOLIS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 214017069 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4102669694 | ||||||||
| FaxNumber: | 4102669695 | ||||||||
| Practice Location | |||||||||
| Address1: | 122 DEFENSE HWY | ||||||||
| Address2: | 210 | ||||||||
| City: | ANNAPOLIS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 214017069 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4102669694 | ||||||||
| FaxNumber: | 4102669695 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/28/2007 | ||||||||
| LastUpdateDate: | 11/13/2013 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | HEXTER | ||||||||
| AuthorizedOfficialFirstName: | DANIEL | ||||||||
| AuthorizedOfficialMiddleName: | P | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4102669694 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | |||||||||
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 | D01113 | 01 | RR MEDICARE | OTHER | 413491500 | 05 | MD | MEDICAID |