Provider Demographics
NPI:1144367400
Name:JAMIESON, DANIEL BALLARD (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:BALLARD
Last Name:JAMIESON
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 1:5610 WARWICK PL
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-5504
Mailing Address - Country:US
Mailing Address - Phone:917-523-1941
Mailing Address - Fax:
Practice Address - Street 1:5610 WARWICK PL
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-5504
Practice Address - Country:US
Practice Address - Phone:917-523-1941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COTL-1946390200000X
CO1946207R00000X
MDD0070726207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program