Healthcare Provider Details

I. General information

NPI: 1487409801
Provider Name (Legal Business Name): GEULAH BEN-DAVID MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2024
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3998 FAIR RIDGE DR
FAIRFAX VA
22033-2907
US

IV. Provider business mailing address

1709 LORRE DR
ROCKVILLE MD
20852-4104
US

V. Phone/Fax

Practice location:
  • Phone: 571-349-2191
  • Fax: 571-349-2211
Mailing address:
  • Phone: 832-219-5280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number48257
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number0101290235
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: