Healthcare Provider Details

I. General information

NPI: 1225263411
Provider Name (Legal Business Name): COURTNEY JAYME CUTLER RAIZMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: COURTNEY JAYME CUTLER MD

II. Dates (important events)

Enumeration Date: 05/18/2009
Last Update Date: 08/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6355 WALKER LN SUITE 308
ALEXANDRIA VA
22310-3245
US

IV. Provider business mailing address

PO BOX 17334
BALTIMORE MD
21297-1334
US

V. Phone/Fax

Practice location:
  • Phone: 703-313-7700
  • Fax: 703-313-0178
Mailing address:
  • Phone: 703-443-6717
  • Fax: 703-443-8643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number0101256912
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: