Provider Demographics
NPI:1083835664
Name:NATHAN, ALAN H (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:H
Last Name:NATHAN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 EAST HAMILTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901
Mailing Address - Country:US
Mailing Address - Phone:301-588-9209
Mailing Address - Fax:
Practice Address - Street 1:8607 CEDAR ST
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4324
Practice Address - Country:US
Practice Address - Phone:301-442-1713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810003351103TC0700X
MD04371103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical