Provider Demographics
NPI:1942224753
Name:HEXTER, DANIEL (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:HEXTER
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:PO BOX 62222
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-2222
Mailing Address - Country:US
Mailing Address - Phone:443-481-6467
Mailing Address - Fax:443-481-6515
Practice Address - Street 1:122 DEFENSE HWY
Practice Address - Street 2:210
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7069
Practice Address - Country:US
Practice Address - Phone:410-266-9694
Practice Address - Fax:410-266-9695
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00662292084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD413491500Medicaid
CAA94903OtherSTATE LICENSE
P00657598OtherRAILROAD MEDICARE
MDD0066229OtherMARYLAND LICENSE
MD240616YHMOMedicare PIN
MD605P256HMedicare PIN