Basic Information
| Provider Information | |||||||||
| NPI: | 1942224753 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HEXTER | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 62222 | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212642222 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4434816467 | ||||||||
| FaxNumber: | 4434816515 | ||||||||
| Practice Location | |||||||||
| Address1: | 122 DEFENSE HWY | ||||||||
| Address2: | 210 | ||||||||
| City: | ANNAPOLIS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 214017069 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4102669694 | ||||||||
| FaxNumber: | 4102669695 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2006 | ||||||||
| LastUpdateDate: | 06/26/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | D0066229 | MD | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
ID Information
| ID | Type | State | Issuer | Description | 413491500 | 05 | MD | MEDICAID | A94903 | 01 | CA | STATE LICENSE | OTHER | P00657598 | 01 | RAILROAD MEDICARE | OTHER | D0066229 | 01 | MD | MARYLAND LICENSE | OTHER |