Healthcare Provider Details

I. General information

NPI: 1013039361
Provider Name (Legal Business Name): ROSS STUART SILVERSTEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3299 WOODBURN ROAD SUITE 400
ANNADALE VA
22003-7335
US

IV. Provider business mailing address

3299 WOODBURN ROAD SUITE 400
ANNADALE VA
22003-7335
US

V. Phone/Fax

Practice location:
  • Phone: 703-876-9067
  • Fax: 703-573-5499
Mailing address:
  • Phone: 703-876-9067
  • Fax: 703-573-5499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101037836
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: