Healthcare Provider Details

I. General information

NPI: 1215028030
Provider Name (Legal Business Name): ACHANA V BALL MD MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3750 OLD LEE HWY
FAIRFAX VA
22030-1870
US

IV. Provider business mailing address

6506 LITTLE FALLS RD
ARLINGTON VA
22213-1209
US

V. Phone/Fax

Practice location:
  • Phone: 703-704-6150
  • Fax: 703-359-6586
Mailing address:
  • Phone: 703-246-7104
  • Fax: 703-359-6589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number0101042699
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: