Provider Demographics
NPI:1346243417
Name:HANSEN, DARCY JEAN (MD)
Entity Type:Individual
Prefix:
First Name:DARCY
Middle Name:JEAN
Last Name:HANSEN
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 1:1145 19TH ST NW
Mailing Address - Street 2:STE 210
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-3736
Mailing Address - Country:US
Mailing Address - Phone:202-223-6199
Mailing Address - Fax:202-223-6799
Practice Address - Street 1:1145 19TH ST NW
Practice Address - Street 2:STE 210
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-3736
Practice Address - Country:US
Practice Address - Phone:202-223-6199
Practice Address - Fax:202-223-6799
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-23
Last Update Date:2019-06-06
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-03-24
Provider Licenses
StateLicense IDTaxonomies
DCMD13443207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC103849Medicare ID - Type Unspecified
DCC61888Medicare UPIN