Healthcare Provider Details

I. General information

NPI: 1851327282
Provider Name (Legal Business Name): C. W. KESSLER, M.D.,PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8301 ARLINGTON BLVD STE T-05
FAIRFAX VA
22031-2902
US

IV. Provider business mailing address

1326 RED HAWK CIR
RESTON VA
20194-1040
US

V. Phone/Fax

Practice location:
  • Phone: 703-208-2273
  • Fax: 703-208-0710
Mailing address:
  • Phone: 703-397-0591
  • Fax: 703-397-0592

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101023952
License Number StateVA

VIII. Authorized Official

Name: DR. CHESTER WILLIAM KESSLER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 703-397-0591