Healthcare Provider Details

I. General information

NPI: 1467465195
Provider Name (Legal Business Name): KERRIE L SHREWSBURY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 01/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3302 GALLOWS ROAD
FALLS CHURCH VA
22042
US

IV. Provider business mailing address

3302 GALLOWS ROAD
FALLS CHURCH VA
22042
US

V. Phone/Fax

Practice location:
  • Phone: 703-207-7100
  • Fax:
Mailing address:
  • Phone: 703-207-7100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101051472
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: