| Doctor Name: | DR. RICHARD WYATT CHILDS |
| NPI Number: | 1902138720 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | D00048201 |
| Business Practice Address: | 10 Center Dr Bldg 10, Crc Room 3e-5330 Bethesda, MD - 208920001 |
| Business Phone Number: | 3015948008 |
| Business Fax Number: | 3014802664 |
| Mailing Address: | 10 Center Dr, Bldg 10, Crc Room 3e-5330 BETHESDA |
| State: | MD |
| Postal Code: | 208920001 |
| Phone Number: | 3015948008 |
| Fax Number: | 3014802664 |
| NPI Enumeration Date: | 02/03/2010 |
| NPI Last Update Date: | 02/03/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 171000000X |
| License Number: | D00048201 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Military Health Care Provider |
| Taxonomy Specialization: | |
| Taxonomy Definition: | Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |