Healthcare Provider Details

I. General information

NPI: 1457404766
Provider Name (Legal Business Name): SONIA JANET SALGADO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 KINGSTOWNE VILLAGE PKWY STE 200
ALEXANDRIA VA
22315-5882
US

IV. Provider business mailing address

704 RUFFORD CT
ACCOKEEK MD
20607-2046
US

V. Phone/Fax

Practice location:
  • Phone: 701-922-3434
  • Fax: 703-922-6588
Mailing address:
  • Phone: 301-292-3248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number0101222620
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: