Provider Demographics
NPI:1831314897
Name:HIRSH, DONALD W (DC)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:W
Last Name:HIRSH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14440 CHERRY LANE CT
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-4946
Mailing Address - Country:US
Mailing Address - Phone:301-490-7785
Mailing Address - Fax:301-604-8834
Practice Address - Street 1:14440 CHERRY LANE CT
Practice Address - Street 2:SUITE 100
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-4946
Practice Address - Country:US
Practice Address - Phone:301-490-7785
Practice Address - Fax:301-604-8834
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01385111NI0013X, 111NR0200X, 111NR0400X, 225100000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner
No111NR0200XChiropractic ProvidersChiropractorRadiology
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD902106000Medicaid
MDF171OtherBCBS OF DC
MD41519201OtherBCBS OF MD RENDERING #
MDKAE9Medicare UPIN