Healthcare Provider Details

I. General information

NPI: 1881788610
Provider Name (Legal Business Name): ORAL ALPAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 10/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6212 OLD KEENE MILL COURT
SPRINGFIELD VA
22152-2355
US

IV. Provider business mailing address

6212 OLD KEENE MILL COURT
SPRINGFIELD VA
22152-2355
US

V. Phone/Fax

Practice location:
  • Phone: 703-569-1133
  • Fax: 703-569-2239
Mailing address:
  • Phone: 703-569-1133
  • Fax: 703-569-2239

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number0101238213
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: