Provider Demographics
NPI:1467828533
Name:DIAL, JAMES JOHNATHAN (CRNA)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:JOHNATHAN
Last Name:DIAL
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6900 WHITTIER BLVD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-6067
Mailing Address - Country:US
Mailing Address - Phone:940-781-4291
Mailing Address - Fax:
Practice Address - Street 1:6900 WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-6067
Practice Address - Country:US
Practice Address - Phone:940-781-4291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-12
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX710989367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered