Provider Demographics
NPI: | 1083694475 |
---|---|
Name: | DARDEN, MICHAEL D (MD) |
Entity type: | Individual |
Prefix: | DR |
First Name: | MICHAEL |
Middle Name: | D |
Last Name: | DARDEN |
Suffix: | |
Gender: | M |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 7517 NEW HAMPSHIRE AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | TAKOMA PARK |
Mailing Address - State: | MD |
Mailing Address - Zip Code: | 20912-6969 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 301-439-6235 |
Mailing Address - Fax: | 301-439-7967 |
Practice Address - Street 1: | 7517 NEW HAMPSHIRE AVE |
Practice Address - Street 2: | |
Practice Address - City: | TAKOMA PARK |
Practice Address - State: | MD |
Practice Address - Zip Code: | 20912-6969 |
Practice Address - Country: | US |
Practice Address - Phone: | 301-439-6235 |
Practice Address - Fax: | 301-439-7967 |
Is Sole Proprietor?: | Not Answered |
Enumeration Date: | 2006-01-20 |
Last Update Date: | 2025-09-11 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MD | D0029247 | 207K00000X, 208000000X |
DC | MD13075 | 208000000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | |
No | 207K00000X | Allopathic & Osteopathic Physicians | Allergy & Immunology |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
DC | 429775 | Medicare ID - Type Unspecified | |
MD | B94893 | Medicare UPIN |