Provider Demographics
NPI:1134265523
Name:NATIONAL INSTITUTES OF HEALTH
Entity type:Organization
Organization Name:NATIONAL INSTITUTES OF HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-496-4256
Mailing Address - Street 1:10 CENTER DRIVE
Mailing Address - Street 2:BLDG. 10 CRC, ROOM 3-3288
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20892-2089
Mailing Address - Country:US
Mailing Address - Phone:301-435-3547
Mailing Address - Fax:301-480-4354
Practice Address - Street 1:10 CENTER DRIVE
Practice Address - Street 2:BLDG. 10 CRC, ROOM 3-3288
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-2089
Practice Address - Country:US
Practice Address - Phone:301-435-3547
Practice Address - Fax:301-480-4354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0060633284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital