Provider Demographics
NPI:1407165053
Name:WALTER REED NATIONAL MILITARY MEDICAL CENTER
Entity Type:Organization
Organization Name:WALTER REED NATIONAL MILITARY MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL MANAGEMENT ANALYST
Authorized Official - Prefix:MS
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DICKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-295-4934
Mailing Address - Street 1:8901 WISCONSIN AVE
Mailing Address - Street 2:PSC BOX 509 CODE 6300
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20889-5600
Mailing Address - Country:US
Mailing Address - Phone:301-295-4934
Mailing Address - Fax:301-295-1299
Practice Address - Street 1:8901 WISCONSIN AVE
Practice Address - Street 2:PSC BOX 509 CODE 6300
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-5600
Practice Address - Country:US
Practice Address - Phone:301-295-4934
Practice Address - Fax:301-295-1299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-30
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital