Doctor Name: | DR. WILLIAM BRADLEY POKORNY |
NPI Number: | 1497036933 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.O. |
License Number: | 0102203221 |
Business Practice Address: | 8901 Wisconsin Ave Building 9, Room 1277 Bethesda, MD - 208895600 |
Business Phone Number: | 3013194462 |
Business Fax Number: | |
Mailing Address: | 8901 Wisconsin Ave, Building 9, Room 1277 BETHESDA |
State: | MD |
Postal Code: | 208895600 |
Phone Number: | 3013194462 |
Fax Number: | |
NPI Enumeration Date: | 08/29/2011 |
NPI Last Update Date: | 07/24/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 0102203221 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |