1821699414 NPI number — DR. ADAM DAVID ALAMILLO AUD

Table of content: DR. ADAM DAVID ALAMILLO AUD (NPI 1821699414)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821699414 NPI number — DR. ADAM DAVID ALAMILLO AUD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALAMILLO
Provider First Name:
ADAM
Provider Middle Name:
DAVID
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
AUD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821699414
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/03/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19110 MONTGOMERY VILLAGE AVE STE 120
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MONTGOMERY VILLAGE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20886-3706
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-977-6317
Provider Business Mailing Address Fax Number:
301-977-8503

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3301 NEW MEXICO AVE NW STE 125
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20016-3609
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-873-2617
Provider Business Practice Location Address Fax Number:
202-967-2800
Provider Enumeration Date:
11/02/2020

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)