Individual provider Active NPI

Emerson Duyugan Maniwang, MD

  • General Practice Physician
  • Bethesda, MD
National Provider Identifier
1205396470
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
0101270250 Issued in VA
Practice address
8901 Wisconsin Ave BLDG 9
Bethesda, MD 20889-5000
Phone
(301) 295-3929
NPI assigned
Mar 22, 2019
Last updated
Aug 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 0101270250 VA Primary

Addresses

Primary practice location

8901 Wisconsin Ave BLDG 9
Bethesda, MD 20889-5000

Mailing address

8901 Wisconsin Ave BLDG 9
Bethesda, MD 20889-0004
Phone (301) 295-3929

Other practice location 1

Naval Medical Center San Diego 38400 Bob Wilson Dr
San Diego, CA 92134-5000
Phone (443) 562-3522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101270250VAMDGeneral Practice Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1205396470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8901 WISCONSIN AVE BLDG 9",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208890004",
            "telephone_number": "301-295-3929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 WISCONSIN AVE BLDG 9",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208895000",
            "telephone_number": "301-295-3929"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Naval Medical Center San Diego 38400 Bob Wilson Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921345000",
            "country_code": "US",
            "telephone_number": "443-562-3522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANIWANG",
        "first_name": "EMERSON",
        "middle_name": "DUYUGAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-22",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0101270250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.