Provider Demographics
NPI:1720058274
Name:NIEBUHR, DAVID WILLIAM (MD, MPH, MSC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:WILLIAM
Last Name:NIEBUHR
Suffix:
Gender:M
Credentials:MD, MPH, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19524 DUBARRY DR
Mailing Address - Street 2:
Mailing Address - City:BROOKEVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20833-2616
Mailing Address - Country:US
Mailing Address - Phone:301-319-9833
Mailing Address - Fax:301-319-9104
Practice Address - Street 1:503 ROBERT GRANT AVE
Practice Address - Street 2:WALTER REED ARMY INST OF RESEARCH, DIV OF PREV MED
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-7500
Practice Address - Country:US
Practice Address - Phone:301-319-9833
Practice Address - Fax:301-319-9104
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101042399207Q00000X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Not Answered2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine