Healthcare Provider Details

I. General information

NPI: 1992103568
Provider Name (Legal Business Name): MEDSTAR MEDICAL GROUP II LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2014
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6355 WALKER LN STE 501
ALEXANDRIA VA
22310-3245
US

IV. Provider business mailing address

3007 TILDEN ST NW STE 5N
WASHINGTON DC
20008-3030
US

V. Phone/Fax

Practice location:
  • Phone: 703-971-3701
  • Fax: 703-971-0958
Mailing address:
  • Phone: 888-896-1400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE SCHNEIDER
Title or Position: VICE PRESIDENT
Credential:
Phone: 703-558-1403