Healthcare Provider Details

I. General information

NPI: 1912179961
Provider Name (Legal Business Name): KARI S KOBER M.S., PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2008
Last Update Date: 10/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2445 ARMY NAVY DR
ARLINGTON VA
22206-2905
US

IV. Provider business mailing address

2445 ARMY NAVY DR
ARLINGTON VA
22206-2905
US

V. Phone/Fax

Practice location:
  • Phone: 703-892-6500
  • Fax: 703-892-1550
Mailing address:
  • Phone: 703-892-6500
  • Fax: 703-892-1550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110002740
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: