Provider Demographics
NPI:1114154879
Name:BLYTH, DANA MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:MARIE
Last Name:BLYTH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:WRNMMC 8960 BROWN DR
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20889-6200
Mailing Address - Country:US
Mailing Address - Phone:301-295-6400
Mailing Address - Fax:
Practice Address - Street 1:WRNMMC 8960 BROWN DR
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-6200
Practice Address - Country:US
Practice Address - Phone:301-295-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-19
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101248962207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine