Provider Demographics
NPI:1407957327
Name:REGIER, DARREL A (MD)
Entity Type:Individual
Prefix:DR
First Name:DARREL
Middle Name:A
Last Name:REGIER
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 1:5101 EDGEMOOR LN
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-2305
Mailing Address - Country:US
Mailing Address - Phone:301-907-7507
Mailing Address - Fax:301-654-2962
Practice Address - Street 1:5101 EDGEMOOR LN
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-2305
Practice Address - Country:US
Practice Address - Phone:301-907-7507
Practice Address - Fax:301-654-2962
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00182432084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDB70952Medicare UPIN