Provider Demographics
NPI:1215912720
Name:WEAR, DOUGLAS JONATHAN (MD)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:JONATHAN
Last Name:WEAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8014 BARRON ST
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-7366
Mailing Address - Country:US
Mailing Address - Phone:301-434-1963
Mailing Address - Fax:202-782-9160
Practice Address - Street 1:6825 16TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20306-6000
Practice Address - Country:US
Practice Address - Phone:202-782-1849
Practice Address - Fax:202-782-9160
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD20949174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist