Provider Demographics
NPI:1750613790
Name:HUNT, DENISE J (MD)
Entity type:Individual
Prefix:DR
First Name:DENISE
Middle Name:J
Last Name:HUNT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DENISE
Other - Middle Name:A
Other - Last Name:JEFFESON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3111 LANCER PL
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-3150
Mailing Address - Country:US
Mailing Address - Phone:301-559-6359
Mailing Address - Fax:
Practice Address - Street 1:3111 LANCER PL
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-3150
Practice Address - Country:US
Practice Address - Phone:301-559-6359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-01
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC16074208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCE69672Medicare UPIN