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NPI Code Detail

MEDICARE: ADRIAN BEAM THOMPSON PA-C

MEDICARE: ADRIAN BEAM THOMPSON PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2300XPrimary Care Clinic/Center
2363A00000XPhysician AssistantPA030477DC

General Provider Information

NPI Number : 1700900834
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADRIAN BEAM THOMPSON PA-C
Provider Business Mailing Address
First Line : 1935 BEAVER LN
Second Line :
City : MC LEAN
State : VA
Zip : 22101-5534
Country : US
Telephone Number : 571-565-6984
Fax Number : 888-885-9203
Provider Business Practice Location Address
First Line : 1530 WILSON BLVD STE 650
Second Line :
City : ARLINGTON
State : VA
Zip : 22209-2455
Country : US
Telephone Number : 571-267-2325
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2007
Last Update Date : 08/05/2024

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