Healthcare Provider Details

I. General information

NPI: 1376456640
Provider Name (Legal Business Name): PRATHER MEDICINE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3541 W BRADDOCK RD
ALEXANDRIA VA
22302-1916
US

IV. Provider business mailing address

610 MADISON ST STE 101-605
ALEXANDRIA VA
22314-1758
US

V. Phone/Fax

Practice location:
  • Phone: 571-521-0931
  • Fax:
Mailing address:
  • Phone: 571-521-0931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINA PRATHER
Title or Position: OWNER
Credential: MD
Phone: 571-521-0931