Provider Demographics
NPI:1710734124
Name:MCINTYRE, DASHAUN D
Entity type:Individual
Prefix:
First Name:DASHAUN
Middle Name:D
Last Name:MCINTYRE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1445 SOUTHERN AVE APT 302
Mailing Address - Street 2:
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-4331
Mailing Address - Country:US
Mailing Address - Phone:202-853-7410
Mailing Address - Fax:
Practice Address - Street 1:1912 SAVANNAH ST SE APT 101
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-7521
Practice Address - Country:US
Practice Address - Phone:202-492-3401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-02
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant