Provider Demographics
NPI:1194809640
Name:DONESKY, DWIGHT L (MD)
Entity type:Individual
Prefix:DR
First Name:DWIGHT
Middle Name:L
Last Name:DONESKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:DWIGHT
Other - Middle Name:L
Other - Last Name:DONESKY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:7502 VALE ST
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-4004
Mailing Address - Country:US
Mailing Address - Phone:301-503-4730
Mailing Address - Fax:301-913-2843
Practice Address - Street 1:7502 VALE ST
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-4004
Practice Address - Country:US
Practice Address - Phone:301-503-4730
Practice Address - Fax:301-913-2843
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00515852084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG49091Medicare UPIN