Provider Demographics
NPI:1457858011
Name:STEVENS, DANIEL JAMES
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:JAMES
Last Name:STEVENS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 DOLLEY MADISON BLVD STE 403
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-3926
Mailing Address - Country:US
Mailing Address - Phone:703-556-8637
Mailing Address - Fax:866-453-6775
Practice Address - Street 1:6130 OXON HILL RD STE 305
Practice Address - Street 2:
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-3168
Practice Address - Country:US
Practice Address - Phone:301-567-5005
Practice Address - Fax:866-453-6775
Is Sole Proprietor?:No
Enumeration Date:2018-04-10
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103301327213ES0103X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery