Healthcare Provider Details

I. General information

NPI: 1669400362
Provider Name (Legal Business Name): GARY EDWARD KAPLAN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 02/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6829 ELM ST. SUITE 300
MCLEAN VA
22101-3845
US

IV. Provider business mailing address

6829 ELM ST. SUITE 300
MCLEAN VA
22101-3845
US

V. Phone/Fax

Practice location:
  • Phone: 703-532-4892
  • Fax: 703-237-3105
Mailing address:
  • Phone: 703-532-4892
  • Fax: 703-237-3105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number0102036817
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number0102036817
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0102036817
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number0102036817
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: