Healthcare Provider Details

I. General information

NPI: 1023056793
Provider Name (Legal Business Name): DARIN MICHAEL UPDYKE PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 SAM PERRY BLVD
FREDERICKSBURG VA
22401
US

IV. Provider business mailing address

PO BOX 888
FREDERICKSBURG VA
22404
US

V. Phone/Fax

Practice location:
  • Phone: 540-741-1167
  • Fax:
Mailing address:
  • Phone: 866-898-7138
  • Fax: 616-975-9824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110001109
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: