Healthcare Provider Details

I. General information

NPI: 1215147715
Provider Name (Legal Business Name): BRITT-MARIE CARSJO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2229 N OAK CT
ARLINGTON VA
22209-1120
US

IV. Provider business mailing address

2229 N OAK CT
ARLINGTON VA
22209-1120
US

V. Phone/Fax

Practice location:
  • Phone: 703-528-7657
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VH0002X
TaxonomyHospice and Palliative Medicine (Obstetrics & Gynecology) Physician
License NumberC43304
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: