Provider Demographics
NPI:1801962642
Name:DEPARTMENT OF NAVY NATIONAL NAVAL MEDICAL CENTER
Entity type:Organization
Organization Name:DEPARTMENT OF NAVY NATIONAL NAVAL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CDR,, MC,USN, HEAD DEP OF RADIOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:T
Authorized Official - Last Name:SEARS
Authorized Official - Suffix:I
Authorized Official - Credentials:MD
Authorized Official - Phone:301-295-5051
Mailing Address - Street 1:8309 FENWAY RD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-2734
Mailing Address - Country:US
Mailing Address - Phone:301-469-0330
Mailing Address - Fax:301-469-0330
Practice Address - Street 1:8901 WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-5600
Practice Address - Country:US
Practice Address - Phone:301-295-5050
Practice Address - Fax:301-295-5779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD D-17560286500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital