Healthcare Provider Details

I. General information

NPI: 1356332050
Provider Name (Legal Business Name): JUN ANTHONY V QUION M.D. FACC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 10/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12710 DARBY BROOK CT
LAKE RIDGE VA
22192-2486
US

IV. Provider business mailing address

12710 DARBY BROOK CT
LAKE RIDGE VA
22192-2486
US

V. Phone/Fax

Practice location:
  • Phone: 703-496-4190
  • Fax: 866-239-6997
Mailing address:
  • Phone: 703-496-4190
  • Fax: 866-239-6997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number0101058310
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: