Healthcare Provider Details

I. General information

NPI: 1023217726
Provider Name (Legal Business Name): ERIC H NORBY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2007
Last Update Date: 11/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3289 WOODBURN RD SUITE 060
ANNANDALE VA
22003-6800
US

IV. Provider business mailing address

3289 WOODBURN RD SUITE 060
ANNANDALE VA
22003-6800
US

V. Phone/Fax

Practice location:
  • Phone: 703-698-5171
  • Fax:
Mailing address:
  • Phone: 703-698-5171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License Number0101041611
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License NumberD0035949
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License NumberBN1451397
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: