Provider Demographics
NPI:1881897544
Name:WALTER REED NATIONAL MILITARY MEDICAL CNTR
Entity type:Organization
Organization Name:WALTER REED NATIONAL MILITARY MEDICAL CNTR
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL MGMT ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DICKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-295-6300
Mailing Address - Street 1:8901 WISCONSIN AVE
Mailing Address - Street 2:PSC BOX 509 CODE 6300
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20889-5600
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:THE PENTAGON
Practice Address - Street 2:CORRIDOR 8
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20310-0001
Practice Address - Country:US
Practice Address - Phone:703-692-8700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WALTER REED NATIONAL MILITARY MEDICAL CNTR
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-06-08
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1100XAmbulatory Health Care FacilitiesClinic/CenterMilitary/U.S. Coast Guard Outpatient
Provider Identifiers
StateIdentifier IDID TypeIssuer
1639130222OtherPARENT FACILITY NPI EFFECTIVE 1 SEP 2011