MEDICARE: DR. GEORGE ANTHONY RESTA III M.D.

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
1	207V00000X	Obstetrics & Gynecology Physician	D0065116	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720078215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE ANTHONY RESTA III M.D.

Provider Business Mailing Address
First Line	:	8110 MAPLE LAWN BLVD STE 235
Second Line	:
City	:	FULTON
State	:	MD
Zip	:	20759-2694
Country	:	US
Telephone Number	:	301-340-8339
Fax Number	:	301-340-9027

Provider Business Practice Location Address
First Line	:	10313 GEORGIA AVE
Second Line	:	STE 202
City	:	SILVER SPRING
State	:	MD
Zip	:	20902-5006
Country	:	US
Telephone Number	:	301-681-9101
Fax Number	:	301-681-3525

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2005
Last Update Date	:	11/29/2023

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