Provider Demographics
NPI:1730316555
Name:ACKERLY, DANA C (MD)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:C
Last Name:ACKERLY
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 1:3301 NEW MEXICO AVE NW STE 342
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-3623
Mailing Address - Country:US
Mailing Address - Phone:202-362-4467
Mailing Address - Fax:202-362-2303
Practice Address - Street 1:3301 NEW MEXICO AVE NW STE 342
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-3623
Practice Address - Country:US
Practice Address - Phone:202-362-4467
Practice Address - Fax:202-362-2303
Is Sole Proprietor?:No
Enumeration Date:2009-06-19
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAL-240151207R00000X
TNMD54022207R00000X, 208100000X
DCMD045878207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation