Healthcare Provider Details

I. General information

NPI: 1710078951
Provider Name (Legal Business Name): INFECTIOUS DISEASE CONSULTANTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 07/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11211 WAPLES MILL ROAD SUITE 200
FAIRFAX VA
22030-7406
US

IV. Provider business mailing address

11211 WAPLES MILL ROAD SUITE 200
FAIRFAX VA
22030-7406
US

V. Phone/Fax

Practice location:
  • Phone: 703-246-9560
  • Fax: 703-246-9564
Mailing address:
  • Phone: 703-246-9560
  • Fax: 703-246-9564

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. STEPHEN E. WEINROTH
Title or Position: SR. MANAGING MEMBER
Credential: M.D.
Phone: 703-246-9560