Healthcare Provider Details

I. General information

NPI: 1851503841
Provider Name (Legal Business Name): BRIDGETT L CASADABAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 03/04/2024
Certification Date: 03/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

431 PARK AVE STE 300
FALLS CHURCH VA
22046-3305
US

IV. Provider business mailing address

431 PARK AVE STE 300
FALLS CHURCH VA
22046-3305
US

V. Phone/Fax

Practice location:
  • Phone: 434-924-8344
  • Fax:
Mailing address:
  • Phone: 434-924-8344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number0101247224
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: