Provider Demographics
NPI:1598180507
Name:WATLER REED NATIONAL MILITARY MEDICAL CENTER
Entity Type:Organization
Organization Name:WATLER REED NATIONAL MILITARY MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GYN ONC
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:STANY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-400-1272
Mailing Address - Street 1:4954 N PALMER RD
Mailing Address - Street 2:BLDG 19, ROOM 3460
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20889-5630
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4954 N PALMER RD
Practice Address - Street 2:BLDG 19, ROOM 3460
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-5630
Practice Address - Country:US
Practice Address - Phone:301-400-1272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-27
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital