Provider Demographics
NPI:1184678856
Name:HWANG, DANIEL (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:HWANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1860 TOWN CENTER DR
Mailing Address - Street 2:SUITE 335
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-5896
Mailing Address - Country:US
Mailing Address - Phone:703-787-3322
Mailing Address - Fax:703-787-3380
Practice Address - Street 1:1860 TOWN CENTER DR
Practice Address - Street 2:SUITE 335
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-5896
Practice Address - Country:US
Practice Address - Phone:703-787-3322
Practice Address - Fax:703-787-3380
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101230426207Y00000X, 207YX0602X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic Allergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA128005Y2COtherMEDICARE
VA7252312OtherAETNA PPO
VA1919939OtherAETNA HMO
VA20-5459893OtherTAX ID
VA3141063OtherUNITED HEALTHCARE
VA354028OtherANTHEM
VA7800121OtherCIGNA
H39999Medicare UPIN