Provider Demographics
NPI:1639335151
Name:NEURO-ONCOLOGY BRANCH
Entity Type:Organization
Organization Name:NEURO-ONCOLOGY BRANCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF, NEURO-ONCOLOGY BRANCH
Authorized Official - Prefix:MR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:FINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-402-8363
Mailing Address - Street 1:9030 OLD GEORGETOWN RD
Mailing Address - Street 2:BLDG. 82, MSC 8202
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20892-0001
Mailing Address - Country:US
Mailing Address - Phone:301-402-6298
Mailing Address - Fax:301-480-2246
Practice Address - Street 1:9030 OLD GEORGETOWN RD
Practice Address - Street 2:BLDG. 82, MSC 8202
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-0001
Practice Address - Country:US
Practice Address - Phone:301-402-6298
Practice Address - Fax:301-480-2246
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATIONAL INSTITUTES OF HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-08-04
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0055925284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDE65268Medicare UPIN