Provider Demographics
NPI:1245301720
Name:SIMS, DOUGLAS LEE JR (DC)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:LEE
Last Name:SIMS
Suffix:JR
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 1:5600 RIVERTECH CT STE G
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20737-1354
Mailing Address - Country:US
Mailing Address - Phone:301-853-7467
Mailing Address - Fax:301-853-7040
Practice Address - Street 1:5600 RIVERTECH CT STE G
Practice Address - Street 2:
Practice Address - City:RIVERDALE PARK
Practice Address - State:MD
Practice Address - Zip Code:20737-1354
Practice Address - Country:US
Practice Address - Phone:301-853-7467
Practice Address - Fax:301-853-7040
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS02036111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD491882Medicare UPIN
MD491882Medicare ID - Type Unspecified