Daza Racines, Enrique
Daza Racines, Enrique is an sole proprietor health care provider with primary practice located at 5602B Shields Dr , Bethesda MD 20817-3571. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Trauma Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Daza Racines, Enrique can be contacted via phone (301) 897-0044.Contact Information
Primary practice address
5602B Shields Dr
Bethesda MD 20817-3571
Phone: (301) 897-0044
Fax: (301) 897-0046
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 19033 | District of Columbia |
| Allopathic & Osteopathic Physicians / Trauma Surgery | 2086S0127X | BD42181 | Maryland |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | D42181 | Maryland |
Profile Details
| NPI number | 1649229634 |
|---|---|
| LBN Legal business name | Daza Racines, Enrique |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 8th, 2006 |
| Last updated | Nov 10th, 2014 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649229634 | NPPES |
| District of Columbia | MEDICAID | 040064400 | |
| District of Columbia | MEDICAID | 025430100 | |
| District of Columbia | MEDICAID | 415096100 |
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