Healthcare Provider Details

I. General information

NPI: 1285609164
Provider Name (Legal Business Name): CARRIE JANE STARKIE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 03/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9430 FORESTWOOD LANE SUITE 100
MANASSAS VA
20110
US

IV. Provider business mailing address

9430 FORESTWOOD LANE SUITE 100
MANASSAS VA
20110
US

V. Phone/Fax

Practice location:
  • Phone: 703-365-0227
  • Fax: 703-365-0332
Mailing address:
  • Phone: 703-365-0227
  • Fax: 703-365-0332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101225046
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: